Methods of treating cancer by administering EMP2 antibodies

ABSTRACT

The present invention provides methods and compositions useful in the treatment or prevention of  Chlamydia  infections and cancer. The methods and compositions inhibit the entry of  Chlamydia  into a host cell expressing EMP2 by interfering with the interaction between the  Chlamydia  and EMP2. The methods and compositions target cancers which express or overexpress EMP2 nucleic acids and polypeptides by targeting EMP2.

CROSS-REFERENCES TO RELATED APPLICATIONS

This application is a Continuation of U.S. application Ser. No.12/682,032 filed Jul. 7, 2010, now U.S. Pat. No. 8,318,906 which is a371 of PCT/US08/79244 filed Oct. 8, 2008 and is a Continuation-in-partof U.S. patent application Ser. No. 11/868,788 filed Oct. 8, 2007, nowU.S. Pat. No. 8,648,052, which is a Continuation-in-part ofPCT/US06/14238 filed Apr. 14, 2006 which claims the benefit under 35U.S.C. §119(e) to U.S. Application No. 60/671,755 filed Apr. 15, 2005,the disclosure of each of which is incorporated by reference in itsentirety.

STATEMENT AS TO RIGHTS TO INVENTIONS MADE UNDER FEDERALLY SPONSOREDRESEARCH AND DEVELOPMENT

This invention was made with Government support under Grant Nos.A1007323, CA009120, CA016042, CA086306, CA119367, GM007185, andHD048540, awarded by the National Institutes of Health. This work wassupported by the U.S. Department of Veterans Affairs. The Government hascertain rights in the invention.

REFERENCE TO A “SEQUENCE LISTING,” A TABLE, OR A COMPUTER PROGRAMLISTING APPENDIX SUBMITTED ON A COMPACT DISK

The sequence listing contained in the file named“008074-5003-US02_ST25.txt” and having a size of 34.9 kilobytes, hasbeen submitted electronically herewith via EFS-Web, and the contents ofthe txt file are hereby incorporated by reference in their entirety.

FIELD OF THE INVENTION

This invention relates anti-EMP2 antibodies, their pharmaceuticalcompositions and methods for using them in detecting and treatingcancers, such as endometrial cancers, which express or overexpress EMP2and in treating or preventing infection by Chlamydia.

BACKGROUND OF THE INVENTION

The epithelial membrane protein-2 (EMP2) is a member of the growtharrest specific-3/peripheral myelin protein-22 (GAS3/PMP22) family oftetraspan proteins. Other four-transmembrane families, connexins andtetraspanins, play roles in gap junctions, cell-cell recognitionprocesses, and intracellular trafficking. Less is known about theGAS3/PMP22 family. The information available mainly relates to theirpotential roles in various diseases. For instance, mutations in theprototypic GAS3 family member PMP22 have been found to causeneurodegenerative disease (i.e., Dejerrine Sottas Syndrome and CharcotMarie Tooth Syndrome). EMP2 has also been implicated in B cell tumorprogression and stress-induced apoptosis.

EMP2 is expressed at high levels in epithelial cells of the lung, eye,and genitourinary tracts. Like several tetraspan proteins (CD9, CD81,PMP22), EMP2 in murine fibroblasts is localized to lipid raft domains.EMP2 controls cell surface trafficking and function of certainintegrins, GPI-linked proteins, and class I MHC molecules, andreciprocally regulates caveolin expression. (see, Claas et al., J BiolChem 276:7974-84 (2001); Hasse et al., J Neurosci Res 69:227-32 (2002);Wadehra et al., Exp Mol Pathol 74:106-12 (2003); Wadehra et al., MolBiol Cell 15:2073-2083 (2004); Wadehra et al., J Biol Chem277:41094-41100 (2002); and Wadehra et al., Clin Immunol 107:129-136(2003)).

Detailed studies of the subanatomic distribution of EMP2 in murine andhuman ocular tissue indicate that EMP2 is localized to epithelial layersof the cornea, ciliary body, and retinal pigmented epithelium-choroid,the stromal layers of the sclera, and the nerve fiber layer of theretina and optic nerve. This distribution is distinct from other TM4SFproteins and may relate to a role in apical membrane recycling.

Endometrial cancer (EC) is the most common gynecological malignancy. Inthe United States, the death rate from EC has doubled in the last twentyyears, and currently a woman has approximately a 3% chance of developingEC during her lifetime (Silverberg et al., World Health OrganizationClassification of Tumors: Tumors of the Breast and Female Genital Tract,Lyon: IARC Press, p. 221-57 (2003); Sorosky J I, Obstet Gynecol111:436-47 (2008)). EC is classified into two major sub-groups based onhistology, clinical behavior, and epidemiology. The more common Type Iis associated with estrogen predominance and pre-malignant endometrialhyperplasia (Hecht et al., J Clin Oncol 24:4783-91 (2006); Sherman, ModPathol 13:295-308 (2000)). Type II is mediated by non-hormonal riskfactors, and often has a high grade or high-risk histology with anaggressive clinical course (Hecht et al., J Clin Oncol 24:4783-91(2006)). Incidence of ECs generally increases with age, with 75-80% ofnew cases occurring in postmenopausal women (Creasman, Semin Oncol24:S1-140-51-50 (1997)).

Primary treatment for ECs is the surgical removal of the tumor, butrecurrence is common, and other therapeutic interventions (radiotherapy,chemotherapy, and endocrine therapy) benefit only a subset of patients(Markman, Semin Oncol 33: S33-8 (2006); Engleman et al., Semin Oncol30:80-94 (2003)). Presently, there are few biomarkers that distinguishECs at the pre-malignant stage, although emerging efforts are targetingmolecules that underlie the process of tumorigenesis (Kelloff et al.,Clin Cancer Res 12:3661-97 (2006); Gossett et al., Int J Gynecol Cancer14:145-51 (2004)). Similarly, there are currently no biomarkers that canbe targeted for tumor suppression and elimination. Thus, new modalitiesfor early detection and treatment of ECs at premalignant and franklymalignant stages of disease are needed to improve management andprognosis.

One promising biomarker appears to be EMP2. EMP2 expression isassociated with EMP2 neoplasia (Wadehra et al., Cancer 107:90-8 (2006)).In endometrial cancer, EMP2 is an independent prognostic indicator fortumors with poor clinical outcome. EMP2 positive tumors, compared toEMP2 negative tumors, had a significantly greater myometrialinvasiveness, higher clinical state, recurrent or persistent diseasefollowing surgical excision, and earlier mortality. As EMP2 expressionwas independent of other known biomarkers such as the estrogen receptorand progesterone receptor (Wadehra et al., Cancer 107:90-8 (2006)), EMP2represents a unique biomarker for patients who are not responsive tocurrent hormone or chemotherapy. Moreover, EMP2 expression levelpositively correlates with the increasing pre-malignant potential ofproliferative endometrium. That is, there is a gradation of endometrialEMP2 expression, with minimal expression in normal proliferative orquiescent premenopausal endometrium, and increasing expression inpatients with disordered proliferative endometrium, endometrialhyperplasia, and endometrium carcinomas.

In the endometrium, EMP2 expression is regulated by progesterone andrequired for successful blastocyst implantation (Wadehra et al., DevBiol292:430-41 (2006); Wadehra et al., Reprod Biol Endocrinol 6:15 (2008)).EMP2 appears to regulate trafficking of various proteins and glycolipidsby facilitating transfer of molecules from post-Golgi endosomalcompartments to appropriate plasma membrane locations. Specifically,EMP2 is thought to facilitate the appropriate trafficking of selectmolecules into glycolipids-enriched lipid raft microdomains (GEMs)(Wadehra et al., Mol Biol Cell 15:2073-83 (2004)). GEMs are cholesterolrich microdomains which are often associated with chaperones,receptosomes, and protein complexes that are important for efficientsignal transduction (Leitinger et al., J Cell Sci 115:963-72 (2002);Moffett et al., J Biol Chem 275:2191-8 (2000)). Moreover, GEMs areinvolved in correct sorting of proteins from the Golgi apparatus toplasma membrane (Abrami et al., J Biol Chem 276:30729-36 (2001);Galbiati et al., Cell 106:403-11 (2001); Gruenberg et al., Curr OpinCell Biol 7: 552-63 (1995)). In this respect, modulation of EMP2expression levels or its location on the plasma membrane alters thesurface repertoire of several classes of molecules including integrins,focal adhesion kinase, class I major histocompatibility molecules andother immunoglobulin super-family members such as CD54 and GPI-linkedproteins (Wadehra et al., DevBiol 287:336-45 (2005); Wadehra et al.,Clinical Immunology 107:129-36 (2003); Morales et al., Invest OphthalmolVis Sci (2008)).

Chlamydiae are obligate gram-negative intracellular prokaryoticpathogens that are responsible for significant human morbidity andinfections of multiple organ systems. More than 90 million new cases ofsexually transmitted, genitourinary Chlamydia trachomatis infection arereported annually. These infections are a significant cause ofinfertility, ectopic pregnancy, and chronic pelvic pain syndromes(Brunham & Rey-Ladino, J. Nat Rev Immunol 5:149-61 (2005)). Ocularinfections with Chlamydia may result in trachoma, the primary cause ofinfectious blindness worldwide (see, Engel, Proc Natl Acad Sci USA101:9947-8 (2004)), and Chlamydia species also have been associated withother inflammatory diseases (see, Hannu et al. Rheumatology (Oxford)38:411-4 (1999), Gencay et al., Am J Respir Crit. Care Med 163:1097-100(2001); Smieja et al., BMC Infect Dis 2:21 (2002); and Dautry-Varsat etal., Traffic 5:561-570 (2004)). The pathophysiology of Chlamydialinfections is only partly understood, in particular identification ofhost cellular proteins involved in Chlamydial infection that may revealnew strategies for disease control.

Chlamydia has a unique biphasic developmental cycle. The first step ininfection requires attachment of a metabolically inactive butinfectious, spore-like structure called the elementary body (EB). Theinitial reversible attachment of EB to epithelial cell layers isproposed to involve a number of Chlamydial and host ligands andadhesions. Possible candidates for attachment mediation include majorouter membrane protein (MOMP), heat shock protein 70, OmcB, heparinsulfate-like glycosaminoglycans, polymorphic outer membrane protein genefamily (pmp), estrogen receptor complex, and caveolae. Upon cellularattachment local actin polymerization, elicited by intracellularsecretion of EB products and tyrosine phosphorylation of various proteinspecies leads to endocytosis of the attached EB. After a few hours, aninternalized EB differentiates into the reticulate body (RB), ametabolically active, non-infectious form which gives rise to >1000progeny EBs, followed by host cell lysis and release of infectious EBsthat begin another life cycle (see, Engel, Proc Natl Acad Sci USA101:9947-8 (2004); Dautry-Varsat et al., Traffic 5:561-570 (2004); Gabelet al., Infect Immun 72:7367-73 (2004); Davis et al., Proc Natl Acad SciUSA 99:9427-32 (2002); Raulston et al., Infect Immun 70:535-43 (2002);Finlay, et al., Science 276:718-725 (1997); and Virok et al., InfectImmun 73:1939-46 (2005)).

Chlamydial infection can result from oral, vaginal, or anal sexualcontact with an infected partner. Chlamydia trachomatis can be sexuallytransmitted. In women, the pathogen can cause pelvic inflammatorydisease (PID) with a risk of tubal obstruction and infertility. In men,the bacteria can cause epidydimitis and infertility. Chlamydia can alsocause acute respiratory tract infections in humans. Infection of the eyewith Chlamydia trachomatis, or trachoma, is a leading cause ofpreventable blindness worldwide. Chlamydial infections are aparticularly serious health threat to newborns who contract occularinfections at birth from infected birth canals of their mothers. Ifuntreated, almost 50% of these children develop inclusion conjunctivitisand 20% develop systemic infection resulting in serious pneumonia.Chlamydia also is likely to exacerbate atherosclerosis. In particular,coronary heart disease has been associated with increased titers ofChlamydia antibodies. In addition, reactive inflammatory arthritis is acommon sequel to sexually acquired non-gonococcal genital tractinfection. Approximately 50% of reactive inflammatory arthritis casesare associated with Chlamydia trachomatis infection of the genitaltract. Chlamydial infection can be asymptomatic and irreversible damagemay have already occurred before treatment is sought.

Accordingly, Chlamydia is a serious public health concern around theworld. However, Chlamydia is an intracellular pathogen which isdifficult to treat. There is no robust vaccine for Chlamydia andconventional antibiotic therapies often fail to clear chronicinfections.

Recent studies indicate that the interaction between Chlamydia and hostcells occurs at specific cholesterol- and glycosphingolipids-rich lipidraft microdomains. Lipid rafts, often experimentally defined by theirinsolubility in cold non-ionic detergents are believed to besubspecialized cell membrane regions important in assembly of receptorsignaling complexes, protein trafficking, endocytic and secretorypathways. Many other proteins associated with bacterial infection havebeen found in lipid raft compartments. Dautry-Varsat et al., Traffic5:561-570 (2004); Simons et al., Nature 387:569-572 (1997); Gabel etal., Infect Immun 72:7367-73 (2004); Claas et al., J Biol Chem276:7974-84 (2001); Brown et al. J Biol Chem 275:17221-4 (2000); andSubtil et al., J Cell Sci 117:3923-33 (2004); and Webley et al., BMCInfect Dis 4:23 (2004).

As reported herein, the Applicants have discovered that EMP2 is a usefultarget for anti-cancer therapy for cancers which express or overexpressEMP2 molecular cell entry and also that EMP2 is a cell entry point forChlamydia. Accordingly, EMP2 polypeptides, anti-EMP2 antibodies, andEMP2 siRNA can be used to modulate the ability of Chlamydia to enter ahost cell to cause infection and disease and can be used also to treatcancers expressing or overexpressing EMP2 As discussed above, thereremains a large need for methods and compositions which are useful inthe prevention, treatment, and modulation of Chlamydia infection as wellas the prevention, diagnosis and treatment of cancer. Accordingly, thisinvention provides novel compositions and methods for meeting these andother needs.

BRIEF SUMMARY OF THE INVENTION

In a first aspect, the invention relates to the discovery thatepithelial membrane protein-2 (EMP2) is a molecular cell entry point forChlamydia Inhibiting the access of Chlamydia to EMP2 can inhibit theability of Chlamydia to enter a host cell and/or to cause infection.Accordingly, in this first aspect, the invention provides pharmaceuticalcompositions comprising EMP2 Chlamydia inhibitors and methods of usingthem in the prevention or treatment of infection with Chlamydia or theentry of Chlamydia into a host cell expressing EMP2. In this firstaspect, the invention provides human-origin antibody sequences whichencode for high-avidity binding proteins specific for EMP2 (e.g., KS49,KS83, KS41, and KS89).

Also in this first aspect, the invention provides pharmaceuticalcompositions comprising these anti-EMP2 antibodies. These antibodies arecapable of specifically binding to the EMP2 of a host cell and ofinhibiting the ability of Chlamydia to enter the host cell or infect ahost. The anti-EMP2 antibody may attach to any epitope of the EMPpolypeptide. In some embodiments the antibody can bind to a polypeptidecomprising the amino acid sequence of SEQ ID NO:1 or SEQ ID NO:2. Insome embodiments, the antibody recognizes an extracellular or externalepitope (e.g., external loop antigen) of EMP2. In any of the aboveembodiments, the anti-EMP2 antibody can be a polyclonal antibody or amonoclonal antibody. In addition, the antibody may further be a humanantibody, a humanized antibody, a chimeric antibody, a recombinantantibody, a diabody, minibody, triabody, or an antibody fragment havingthe light and heavy variable chain sequences or CDRs corresponding tothe KS49, KS83, KS41, and KS89 sequences disclosed herein.

In this first aspect, the invention also accordingly provides for theuse of an anti-EMP2 antibody in the manufacture of a medicament fortreating Chlamydia.

In some embodiments, the above described pharmaceutical compositionswhich comprise the anti-EMP2 antibody are formulated for topicalapplication to the surface of the eye or a mucosal surface. In someadditional embodiments of the above, the pharmaceutical compositions areformulated as part of an antibiotic composition which may be a cream,lotion, gel or ointment. These antibiotics include, but are not limitedto, azithromycin, amoxicillin, doxycycline, erythromycin, erythromycinethylsuccinate, ofloxacin and levofloxacin. In some further embodiments,the pharmaceutical compositions according to the invention areformulated as part of a contraceptive composition which may be a cream,lotion, ointment, or gel comprising a spermicidal agent. In still otherembodiments, the pharmaceutical compositions of the invention areformulated with a lubricant. In some embodiments, the EMP2 Chlamydiainhibitor is formulated as an intravaginal or condom-coating medicamentincluding, but not limited to, ointments, lotions, gels, and creams.

In still other embodiments of the above pharmaceutical compositionswhich comprise an anti-EMP2 antibody, the compositions are formulatedfor topical administration to the eye. These compositions may beco-formulated with an antibiotic useful in treating Chlamydia infection.

In addition, the invention also provides methods of treating Chlamydiainfections using the above-described pharmaceutical compositions. Inthis first aspect, the invention also provides methods for treating orpreventing infection with Chlamydia in a subject by administering apharmaceutical composition comprising a therapeutically effective amountof an anti-EMP2 antibody to the subject. In some embodiments, the personto be treated has been diagnosed as having a Chlamydia infection or hasor will engage in behavior which places them at risk for such infection.In some embodiments, the Chlamydia species is C. trachoma. In someembodiments, the subject is a person who is infected with Chlamydia andhas been diagnosed with conjunctivitis, pelvic inflammatory disease,arteriosclerosis, elevated C-reactive protein, arthritis, a urogenitaltract infection or pneumonia exacerbated or associated with infection byChlamydia. In some embodiments, the subject is also treating with anantibiotic useful in treating Chlamydia infections. These antibioticsinclude, but are not limited to, azithromycin, amoxicillin, doxycycline,erythromycin, erythromycin ethylsuccinate, ofloxacin and levofloxacin.

In this first aspect, the invention also provides compositions ofanti-EMP2 antibodies which can be used to inhibit or prevent the entryof Chlamydia into a host cell which expresses EMP2 or is otherwise iscapable of expressing EMP2. The EMP2 Chlamydia antibodies may beformulated in a physiologically acceptable carrier, preferably, sterile.

In each of the above embodiments, the host cell or subject to be treatedcan be human, primate, or mammal (e.g., mouse, rat, rabbit) or bird. Infurther embodiments of any of the above aspects, the Chlamydia is C.trachoma.

In a second aspect, the present invention relates to the EMP2 protein asa molecular target in the diagnosis and treatment of cancer.Accordingly, in this second aspect the invention provides methods ofdiagnosis and prognosis for individuals having, or suspected of having,or at increased risk for cancers that express or overexpress EMP2protein or an EMP2 mRNA transcript (e.g., endometrial cancer, ovariancancer, glioblastoma, breast cancer, prostate cancer, testicular cancer,and myeloma). The diagnostic methods generally comprise testing tissuesample from an individual having or suspected of having a cancer thatoverexpresses EMP2 protein or mRNA transcript and determining thepresence or absence or amount of EMP2 protein or mRNA transcript in thetissue relative to a control tissue sample from an individual or siteknown to be negative for cancer. Typically, the tissue sample is serum,but can also be biopsy tissue, including tissue from the affectedtissue.

Further, in this second aspect, the EMP2 markers can help in theprognosis of whether a cancer will progress to a treatment resistant orhormone independent state, become invasive, and/or metastasize. Thepresent invention further provides methods of inhibiting the growth ofand promoting the regression of a cancerous tumor that expresses oroverexpresses EMP2 by contacting the cancer with anti-EMP2 antibody.

In some embodiments, the invention provides methods of diagnosing acancer in a subject by determining the level of EMP2 protein expressionor activity in a biological sample or biopsy of the cancer or tumor fromthe subject wherein an increased level of EMP2 is indicative of cancer.In some embodiments, determining the EMP2 protein levels involves stepsof (a) contacting a tissue sample or biopsy from the subject with anantibody that specifically binds to EMP2 protein; and (b) determiningwhether or not EMP2 protein is overexpressed in the sample or biopsy;thereby diagnosing the cancer. In a further embodiment of such, thecancer can be endometrial cancer, ovarian cancer or a glioblastoma. Insome further embodiments, still the tissue sample can be a needlebiopsy, a surgical biopsy or a bone marrow biopsy. A tissue sample canbe fixed or embedded in paraffin. A tissue sample can be, for instance,from the endometrium, ovary, or brain. The antibody in some embodimentsis a monoclonal antibody or a diabody.

In other embodiments of the second aspect, the method indirectlydetermines the EMP2 protein level by (a) contacting a tissue sample witha primer set of a first oligonucleotide and a second oligonucleotidethat each specifically hybridize to EMP2 nucleic acid; (b) amplifyingthe EMP2 nucleic acid in the sample; and (c) determining whether or notEMP2 nucleic acid is overexpressed in the sample; thereby diagnosing thecancer. The first oligonucleotide can comprise a nucleotide sequence ofEMP2 cDNA and the second oligonucleotide can comprise a nucleotidesequence complementary to that of EMP2 cDNA. Preferably, bothnucleotides are less than 50 base pairs in length. In a preferredembodiment, the cancer is endometrial or ovarian cancer.

In this second aspect, the invention also provides a method of prognosisfor a cancer that overexpresses EMP2 by assessing the likelihood thatthe cancer will be invasive, metastasize, recur or be resistant totherapy. In a first embodiment in this aspect, the invention provides amethod of further diagnosing a cancer that overexpresses EMP2 hasincreased EMP2 transcriptional activity and therefore has an increasedlikelihood of invasiveness, metastasizing, recurrence or resistance totherapy. The method comprises the steps of (a) contacting a tissuesample with an antibody that specifically binds to EMP2; and (b)determining whether or not the EMP2 is overexpressed in the sample;thereby diagnosing the cancer that overexpresses EMP2. The cancer may bediagnosed before or after obtaining and analyzing the sample for EMP2expression or activity levels. The cancer may have been identified onthe basis of histological appearance and not on the basis of the EMP2level determination. The cancer can have been diagnosed as such with orwithout, or despite, knowledge of an elevated EMP2 level. In somefurther embodiments, still the tissue sample can be a needle biopsy, asurgical biopsy or a bone marrow biopsy. A tissue sample can be fixed orembedded in paraffin. A tissue sample can be, for instance, from theendometrium, ovary, or brain. The antibody in some embodiments is amonoclonal antibody or diabody.

In yet other embodiments in this second aspect, the invention provides amethod of targeting patients for more aggressive or alternative cancertherapy or increased surveillance for a cancer recurrence based upon anelevated level of EMP2 in a tissue sample from the patient taken before,during, or after surgical removal of the cancerous tissue before,during, or after another cancer treatment. The EMP2 activity orexpression levels can be determined as described above.

In some further embodiments, the invention provides a method of treatingor inhibiting a cancer, a therapy resistant cancer, a metastasis ofcancer, or recurrence of cancer, that overexpresses EMP2 in a subjectcomprising administering to the subject a therapeutically effectiveamount of one or more inhibitors of EMP2 expression. The cancer thatoverexpresses EMP2 can be, for instance, endometrial cancer, ovariancancer, glioblastoma, breast cancer, prostate cancer, testicular cancer,and myeloma. The compound can be a compound as identified in thefollowing aspect. The overexpression can be identified as described inthe previous aspects. The compound can be administered concurrently withanother cancer therapy.

In a different therapeutic approach, the treatment includes theadministration of a progesterone or other non-estrogenic progesteronesteroid to increase tissue expression of EMP2 so as to increase thesensitivity of the cancers to a therapy targeting cells expressing orover-expressing EMP2. The steroid can be a progesterone derivative(e.g., hydroxyprogesterone caproate, medroxyprogesterone acetate, ormegestrol acetate). The therapy targeting the EMP2 can be an anti-EMP2antibody as disclosed herein. In some embodiments, the anti-EMP2antibody is a diabody. Optionally, the antibody or diabody may befurther conjugated to, or covalently attached to, an antineoplasticagent.

In this second aspect, the invention also provides a method ofidentifying a compound that inhibits cancer, therapy resistant cancer,or metastasis, or a recurrence of cancer, the method comprising thesteps of contacting a cell with a compound; and determining the effectof the compound on the expression or activity of the EMP2 polypeptide inthe cell; wherein compounds which decrease the EMP2 expression oractivity levels are identified as being able to inhibit cancer, itsmetastasis, or progression to a hormone-independent or treatmentresistant state. In some embodiments, the compound increases theexpression of EMP2 in the target cell.

The invention also provides a method of localizing a cancer thatoverexpresses EMP2 in vivo, and is therefore likely to be invasive,likely to metastasize, become hormone independent, or refractory totreatment, the method comprising the step of imaging in a subject a celloverexpressing EMP2. In some embodiments, the cancer that overexpressesEMP2 is selected from the group consisting of endometrial cancer,ovarian cancer, glioblastoma, breast cancer, prostate cancer, testicularcancer, and myeloma.

In addition, EMP2 proteins and EMP2-encoding nucleic acid molecules maybe used in various immunotherapeutic methods to promote immune-mediateddestruction of cancers particularly, when such tumors are invasive.

In some embodiments, the invention provides methods of treating cancer,particularly an invasive cancer or a metastasis, or preventing theprogression of a cancer to a treatment resistant, hormone-independent,or metastasizing state by administering antibodies that bind to EMP2 toreduce their respective activity in the patient. Additionally, in someother embodiments, the antibodies are conjugated to effector moietieswhich thereby are preferentially cytotoxic to cells overexpressing theEMP2. In some embodiments, the antibodies are diabodies or humanizedmonoclonal antibodies.

In some embodiments, the invention provides methods of treating canceror preventing the progression of a cancer to a treatment resistant,hormone-independent, or metastasizing state by administration of RNAimolecule or an antisense molecule specific for EMP2 and whichaccordingly are capable of inhibiting the expression of EMP2. In someembodiments, the RNAi molecule may be a short hairpin RNAi.

In this second aspect, the invention also provides EMP2 polypeptides,anti-EMP2 antibodies, and EMP2 siRNA which would be of use in treatingor preventing cancers which overexpress EMP2. EMP2 is overexpressed in anumber of classes of tumor, including endometrial cancer, ovariancancer, glioblastoma, breast cancer, prostate cancer, testicular cancer,and myeloma. EMP2 antibodies may be used in diagnosis, prognosis, or thetreatment of a cancer alone or when conjugated with an effector moiety.EMP2 antibodies conjugated with toxic agents, such as ricin, as well asunconjugated antibodies, may be useful therapeutic agents naturallytargeted to EMP2 bearing cancer cells. Such antibodies can be useful inblocking invasiveness. EMP polypeptides and nucleic acids may be used invaccine therapies for the cancer.

In any of the above aspects and embodiments, the tissue, cancer,subject, or patient to be treated is human or mammalian. In furtherembodiments, the cancer can be selected from endometrial cancer, ovariancancer, glioblastoma, breast cancer, prostate cancer, testicular cancer,and myeloma. In still further embodiments, the anti-EMP2 antibody orEMP2-binding protein has the CDR or light and chain variable sequencesfor the KS49, KS83, KS41, and KS89 diabodies disclosed herein.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1A-C. Illustration that EMP2 is targeted to lipid rafts and isdisrupted following MβCD treatment. (a, b) Lipid raft fractionation byBrij 58 insolubility. HEC1A were lysed in 1% Brij 58, and centrifuged ina sucrose density gradient. Ten fractions (400 μl each) were collectedfrom the gradient top and tested for (a) GM1 ganglioside by choleratoxin dot blot and (b) EMP2 (˜M_(r) 20 kDa) using SDS-PAGE and westernanalysis. (c) Cholesterol dependence of EMP2 lipid raft fractionation.HEC1A cells were preincubated in the absence (−) or presence (+) ofMβCB, or repleted with cholesterol after MβCB treatment. Cells were thenlysed in 1% Triton X-100, gradient fractionated, and EMP2 detected bywestern analysis. Experiments were performed independently three timeswith similar results.

FIG. 2A-B. Illustration of anti-EMP2 antibody inhibition of Chlamydialinfection. (a) Effect of anti-EMP2 antibody. HEC1A were infected with C.trachomatis (an 8-strain mix of human serovars D-K) in the presence ofindicated concentrations of anti-EMP2 or control pre-immune antibody.Chlamydial infection efficiency (% Chlamydia inclusions compared tountreated cells) was determined by immunostaining (mean±SEM), andcompared at each antibody concentration by student's t test. (b) Effectof EMP2 peptide on anti-EMP2 inhibition. Anti-EMP2 (5%) was pretreatedwith indicated concentrations of specific EMP2 (second extracellularloop) peptide or control peptide, and then coincubated with cells duringChlamydia infection. Infection efficiency was normalized to Chlamydiainclusions in cells without peptide treatment, and compared at eachconcentration of EMP2 or control peptide. Results are representative of2 or more independent experiments.

FIG. 3A-C. Illustration that EMP2 expression levels positively correlatewith Chlamydial infection efficiency. (a) EMP2 levels were compared byanti-EMP2 western immunoblot in HEC1A cells stably transfected withplasmids for expression of a human EMP2-GFP fusion protein(HEC1A-hEMP2), GFP (HEC1A-GFP), or a EMP2-specific ribozyme(HEC1A-hRZ2). Shorter and longer exposures are shown for the hEMP2-GFPfusion protein (48 kDa) and native EMP2 (20 kDa), respectively. Westernimmunoblot for β-actin is shown as a loading control. (b, c) Cells wereinfected with (b) C. trachomatis (a mixture of 8 strains comprisingserovars D-K) or (c) C. muridarum (MoPn), and Chlamydia inclusions (%HEC1A-GFP control cells) were scored (mean±SEM) and compared bystudent's t test to HEC1A-GFP. Data in (b) and (c) are compiled from 5independent experiments, and each experiment had at least threereplicate groups.

FIG. 4A-B. Illustration that EMP2 affects Chlamydia EB attachment. (a)HEC1A-GFP, HEC1A-hEMP2, and HEC1A-hRZ2 were incubated with C.trachomatis EBs for 1.5 hrs at 4° C., and the number of attached EB percell was scored by immunofluorescence with anti-Chlamydial LPS. Valuesare mean±SEM. More than 800 cells scored per experimental group, and 4independent experiments were performed. Groups were compared toHEC1A-GFP by equal variance t-test. (b) Representativeimmunofluorescence microscopy (magnification, 1000×) of HEC1A sublinesafter EB attachment, stained for EB (anti-Chlamydial LPS; Texas Red),F-actin (FITC-phalloidin), and nuclei (DAPI, blue). (c) HEC1A cells wereincubated with Chlamydia EB alone (medium), or in the presence ofanti-EMP2 or control antibody (2.5%). EB attachment was analyzed as inFIG. 4 a; anti-EMP2 and control antibody groups were statisticallycompared to the medium alone group.

FIG. 5A-C. Depiction of a chimeric antibody for use according to theinvention as may be made by use of phage display methodology.

FIG. 6A-B. (A) Sequence and structure of EMP2 molecule. A 24 amino acidpeptide from the small extracellular loop was used to generate theanti-EMP2 recombinant Abs. (B) Example of a single chain diabody withtwo V regions (40)(4).

FIG. 7. Flow cytometry showing reactivity against the EMP2 expressingcells with the anti-EMP2 diabody (clone KS83) and no reactivity with acontrol diabody (clone A10).

FIG. 8A-B. Mice were hormonally synchronized and vaginally pretreatedwith PBS, 10 μg/mouse of control or anti-EMP2 diabody (clone KS83) andmice were infected (day 0) with MoPn as described in the text. A) Swabswere collected 3 days after infection and B) regions of the FGT: OD,oviducts; UH, uterine horn and CV, cervical-vaginal, were collected thefollowing day, homogenized, and IFUs determined. Brackets indicatestatistical comparisons, *p<0.05, **p<0.005, ***p<0.0001 by two-tailedStudent's t test, n=16/grp. Data are compiled from 2 experiments.

FIG. 9A-F. The GT regions from mice pretreated with anti-EMP2 diabodyKS83 (A, C & E) or control A10 (B, D & F) were harvested after 24 hoursand IHC staining was performed on formalin-fixed, paraffin-embeddedsections with a 1:500 dilution of anti-EMP2 immune sera. Arrow: EMP2expression in epithelial cells & arrowhead: EMP2 staining of ova, inset.

FIG. 10. FGT tissues from pretreated mice were collected 4 days afterinfection, homogenized and the supernatant collected followingfiltration through 0.22 μm filters and stored at −80° C. pending theELISA assay. Protein ELISA for IFNγ was performed using a commercial kit(eBioscience). IFNγ protein levels were determined and expressed as pgper milligram of tissue collected. Data are expressed as the mean+SD ofpicograms IFNγ per mg of protein. Brackets indicate statisticalsignificance, *p<0.05, Student's t-test, n=16/grp.

FIG. 11. Mice were pretreated with diabodies or vehicle and infected GTwere collected 4 days later, treated with collagenase and stained withCD4, CD3, Ly6G and CD45. Each data point is a pool of 10 mice showingthe numbers of or Ly6G+CD4-CD3-neutrophils.

FIG. 12A-C. Formalin-fixed, paraffin-embedded sections of UH wereobtained from ovarectomized CF-1 mice 3 days after receivingprogesterone (A) estradiol (B), or no hormonal treatment (C) and IHCstained with anti-murine EMP2 sera. Magnification left (100×) and right(400×).

FIG. 13. Effects of no antibody (PBS), control diabody, and testantibody in the tissue indicated. Five-week old BALB/c mice wereintravaginally pre-treated for 30 min with PBS, control diabody (A10),or anti-EMP2 diabody (KS49), prior to the infection with C. muridarum(MoPn). Left, gross pathology at day 14; Middle, histopathology withhematoxylin and eosin at day 3 (200× magnification). Note recruitment oflymphocyte aggregates (arrows) and fibrosis (arrowheads). Right,histopathology (200× magnification) with trichrome stain, where blueindicates collagen deposition related to fibrosis.

FIG. 14. Effects of no antibody (PBS), control diabody, and testantibody in the tissues indicated. Five-week old BALB/c mice wereintravaginally pre-treated for 30 min with PBS, control diabody (A10),or anti-EMP2 diabody (KS49), prior to the infection with C. muridarum(MoPn). Genital tracts were obtained at day 3, 7, and 14 afterinfection, and divided into oviduct (UGT), uterine horn (MGT), andcervico-vaginal (LGT) segments. Histologic sections from each segmentwere quantitatively scored from 10-20 mice; mean±SEM are shown.Student's t test comparisons are shown (*, p<0.05; ***, p<0.001).

FIG. 15A-D. Biochemical characterization of constructed diabodies. (A)SDS-PAGE and Coomassie staining analysis of purified diabodies. Lane 1:KS49; Lane 2: KS83. Arrow indicates an appropriate molecular weight ofdiabody monomer. (B) Size-exclusion FPLC of purified diabody on aSuperdex 75 column. Retention time of each sample was compared withappropriate molecular weight standards. (C) ELISA dose-response assay ofKS49 diabody. Plates were coated with hEMP2 peptides, and 10-folddilutions (1:10-1:1×10⁵) of the diabody preparations were assayed forbinding. (D) ELISA dose-response assay of KS83 diabody. Plates werecoated with mEMP2 peptides, and 10-fold dilutions (1:10 to 1:1×10⁶) ofthe diabody preparations were assayed for binding. For (C) and (D), EC₅₀was calculated. Results are representative of 3 independent experiments.

FIG. 16. Cellular binding analysis of purified diabodies using flowcytometry. Cellular binding of purified diabodies (labeled on right) wastested on RL95-2, Ishikawa, and NIH 3T3 cells using flow cytometry.Three independent experiments were performed with similar results; arepresentative graph is shown.

FIG. 17A-D. Diabodies induce cytostasis. 0-to-25 μg/ml of diabody KS83(A) or KS49 (B) were added to endometrial carcinoma cell lines HEC-1A,Ishikawa, and RL95-2 in triplicate for 24 hours. Cytostasis wascalculated as the ratio of final/initial cells plated using theabsorbances at 595 nm. (C) Western immunoblots for EMP2 from extracts ofHEC-1A/V and HEC-1A/EMP2. Western immunoblot for β-actin was used as aloading control. (D) 25 μg/ml of diabodies KS83, KS49 or the controldiabody A10 were added to HEC-1A vector control cells (HEC-1A/V) orcells that overexpress EMP2 (HEC-1A/OE) in triplicate for 24 hours.Comparison by student's t test, *p<0.05.

FIG. 18A-C. Diabodies promote apoptosis. (A) RL95-2, (B) HEC-1A/V, and(C) HEC-1A/OE cells were incubated with 12.5 μg/ml KS49, KS89, or A10(control) diabody for 24 hours. Cells were washed and stained withannexin V and 7AAD. Staining is expressed as the % annexin V-7AADpositive cells above the isotype control. The experiment was repeated 3times with similar results; a representative graph is depicted.

FIG. 19A-D. Progesterone augments diabody mediated apoptosis. (A) RL95-2cells were treated with progesterone P4 (25 μM) or vehicle control(ethanol) in combination with 12.5 μg/ml KS49, KS89, or A10 (control)diabody for 24 hours. Cells were stained for annexin V and propidiumiodide, and apoptosis and cell death were further quantitated using flowcytometry. Staining is expressed as the % annexin V-propidium iodidepositive cells above the isotope control. (B) RL95-2 cells were treatedwith progesterone P4 (25 μM) or vehicle control (ethanol) and diabodiesKS83, KS49, or A10 for 72 hours. Cell death was determined by trypanblue exclusion, and depicted as a % of the total number of cellscounted. *p<0.05 (C) EMP2 expression, apoptosis and cell death werefurther quantitated using western blot analysis. Western immunoblots forEMP2 from extracts of RL95-2 cells cultured for 72 hours with 25 μMprogesterone (P4) or a vehicle control (VC; ethanol). Cleaved caspase 3(Δ caspase 3) was assessed after 24 hours of treatment. β-actin servesas the loading control. The experiment was repeated 3 times, and arepresentative graph is depicted. (D) Statistical analysis of cleavedcaspase 3 relative to β-actin expression, compared by student's t test;*p<0.05.

FIG. 20A-D. Anti-EMP2 diabodies reduce tumor load in vivo. (A) HEC-1A/Vor HEC-1A/OE cells were injected s.c. into nude Balb/c female mice (leftpanel). At day 13 (arrow), mice were injected twice a week with 1 mg/kgof anti-EMP2 diabody 83, control diabody A10, or sterile saline. Tumorvolume was calculated using calipers. n=6. (B) EMP2 expression wasanalyzed in untreated tumors using immunohistochemistry using EMP2antisera or control antisera. Magnification: 20×. (C, D) At day 31, micewere euthanized and tumor histology was assessed by hemotoxylin andeosin staining. A representative panel depicts excised tumors (left;scalebar, m) and the corresponding histology (right; 40× magnification)for HEC-1A/V (C) and HEC-1A/OE (D). Comparison by student's t test,*p<0.05.

FIG. 21. Four different human ovarian cancer cell lines (OVCAr5, CAOV-3,OVCA 432, OVCA433) were cultured for 48 or 72 hours with 20 microgram/mLdiabody in RPMI1640 plus fetal calf serum (10%). 40,000 cells wereplated at time zero per well, and the number of viable cells werecounted at each of these times. In addition, the percentage of deadcells was scored by trypan blue exclusion. A10, negative controldiabody; KS49 and KS83, anti-EMP2 diabodies.

FIG. 22. The human glioblastoma cell line ES was cultured for 72 hourswith 20 microgram/mL diabody, with or without progesterone (P4), inRPMI1640 plus fetal calf serum (10%). The percentage of viable cells wasscored by trypan blue exclusion, and results from triplicate groups werepresented as mean±SEM. A10, negative control diabody; KS49 and KS83,anti-EMP2 diabodies.

FIG. 23. Nude mice were subcutaneously inoculated with Hec1a (humanendometrial carcinoma). When tumor formation reached ˜1 cm, mice wereintravenously administered with [124]iodine-diabody (25 micrograms, 100microcuries). 72 hours after administration of diabody, mice were imagedwith microPET and CT. A10, negative control diabody; KS83, anti-EMP2diabody.

FIG. 24. The amino acid sequences of the Heavy and Light chain variableregions of anti-EMP-2 antibodies KS49, KS41, KS89 and KS83 are shown.Suitable CDR sequences of the variable regions are identified using theKabat CDR definition.

FIG. 25. The amino acid sequences of the Heavy and Light chain variableregions of anti-EMP-2 antibodies KS49, KS41, KS89 and KS83 showing thesuitable CDR sequences for use in the antibodies of the invention.

FIG. 26. The amino acid sequences of the KS49, KS41, KS89 and KS83diabodies with underlining of their linkers and polyhistidine tags.

DETAILED DESCRIPTION

Chlamydiae are bacterial pathogens which have evolved efficientstrategies to enter, replicate, and persist inside host epithelialcells, resulting in acute and chronic diseases of humans and otheranimals. Understanding the molecular basis of initial Chlamydialattachment and entry is necessary to form strategies for prevention andtreatment. However, few molecules of either Chlamydial or host originhave emerged as candidates for these processes, and the precisemechanism of infection has not been elucidated. Epithelial membraneprotein-2 (EMP2) is a 4-transmembrane protein, highly expressed inepithelial cells of common sites for Chlamydial infection.

The Applicants have discovered that EMP2 resides in lipid rafts and isthe target membrane microdomain for Chlamydial infection. They have alsofound that Chlamydial attachment and infection efficiency is linked tolevels of EMP2 expression in HEC1A endometrial cells. Either blockingsurface EMP2 with anti-EMP2 antibody or recombinant knockdown in EMP2expression reduced both Chlamydial attachment and infection efficiency,whereas these processes were markedly augmented when EMP2 wasrecombinantly overexpressed. These findings indicate that EMP2 is a newhost protein involved in Chlamydia attachment and infection.

Accordingly, in its first aspect, the invention provides compositions ofanti-EMP2 antibodies in a physiologically acceptable carrier or apharmaceutically acceptable carrier and methods of treating Chlamydiainfections or preventing the entry of Chlamydia into a host cell usingthe anti-EMP2 antibodies.

Human monovalent anti-EMP2 antibody fragments were isolated from a humanphage display library, and engineered as bivalent antibody fragments(diabodies) with specificity and avidity to both EMP2 peptides andnative cell-surface EMP2 protein. The efficacy of these diabodies wereassessed using cell death and apoptosis assays using endometrial cancercells. In addition, the efficacy of EMP2 diabodies on EC tumors wasdetermined using mouse xenograft models.

Treatment of human endometrial adenocarcinoma cell lines with anti-EMP2diabodies was found to induce significant cell death and caspase 3cleavage in vitro. These responses correlated with cellular EMP2expression, and were augmented by progesterone (which physiologicallyinduces EMP2 expression). In vivo, treatment of subcutaneous humanxenografts of HEC-1A cell lines with anti-EMP2 diabodies suppressedtumor growth, and induced striking xenograft cell death.

Accordingly, in its second aspect, the invention provides compositionsof EMP2 inhibitors in a physiologically acceptable carrier or apharmaceutically acceptable carrier and methods of treating cancerswhich express or overexpress EMP2.

In both aspects, the invention provides exemplary anti-EMP2 antibodiesfor use in the diagnosis and treatment of cancer as well as for thetreatment and prevention of infection by Chlamydia.

DEFINITIONS

Unless otherwise stated, the following terms used in the specificationand claims have the meanings given below.

It is noted here that as used in this specification and the appendedclaims, the singular forms “a,” “an,” and “the” include plural referenceunless the context clearly dictates otherwise.

Chlamydiae are obligate intracellular bacteria that infect animals,including mammals and birds, particularly at the epithelial lining ofthe lung, conjunctivae or genital tract. The term “Chlamydia” referencesthe most common species of Chlamydia (i.e., Chlamydia trachomatis,Chlamydia psittaci, Chlamydia pecorum and Chlamydia pneumoniae).Recently, the newly designated species of Chlamydia, C. pneumoniae(formerly C. trachomatis TWAR) has been implicated as a major cause ofepidemic human pneumonitis and perhaps may play a role inatherosclerosis.

“Inhibitors” are agents that inhibit a recited activity, function orentity. For example an inhibitor of Chlamydia infection blocks orreduces the ability of a Chlamydia bacteria to cause an infection. Aninhibitor of Chlamydia entry into a host cell is an agent which blocks,prevents, decreases, reduces, or delays the entry of the bacteria intothe host cell. An inhibitor of EMP2 binding to an anti-EMP2 antibody isan agent which reduces or competes with the binding of the EMP2 to theanti-EMP2 antibody.

An “EMP2 inhibitor” is an agent which interferes with the function,activity, or levels of EMP2. A EMP2 inhibitor can be EMP2 polypeptide;an anti-EMP2 antibody; an EMP2 siRNA molecule; an EMP2-ribozyme; acompound which competes with binding of to EMP2, or an agent or compoundwhich inhibits the expression, transcription, or translation of EMP2nucleic acids in a host cell. In some embodiments, the EMP2 inhibitorsare provided in a composition also comprising a sterile carrier and/orphysiologically acceptable carrier.

Accordingly, in the first aspect of the invention, an “EMP2 Chlamydiainhibitor” is an agent which interferes with the ability of Chlamydia toinfect a host cell by interfering with Chlamydia's ability to interactwith, or bind to, EMP2 of the host cell. A EMP2 Chlamydia inhibitor canbe EMP2 polypeptide; an anti-EMP2 antibody; an EMP2 siRNA molecule; anEMP2-ribozyme; a compound which competes with binding of Chlamydia toEMP2, or an agent or compound which inhibits the expression,transcription, or translation of EMP2 nucleic acids in a host cell. Insome embodiments, the EMP2 Chlamydia inhibitors are provided in acomposition also comprising a sterile carrier and/or physiologicallyacceptable carrier.

A “host cell” is a living cell which is capable of being infected withChlamydia and expresses EMP2. Exemplary host cells are mammalianepithelial cells, including epithelial cells of the mucosa or eye. Thehost cells may be in vivo or in vitro.

Modulators are agents which can increase or decrease a referencedactivity. Modulators include inhibitors and activators which haveeffects opposite to inhibitors (e.g., increase, stimulate, augment,enhance, accelerate) a referenced activity or entity.

The amino acid sequence of an EMP2 polypeptide according to theinvention 1) comprises, consists of, or consists essentially of an aminoacid sequence that has greater than about 60% amino acid sequenceidentity, 65%, 70%, 75%, 80%, 85%, 90%, preferably 91%, 92%, 93%, 94%,95%, 96%, 97%, 98% or 99% or greater amino acid sequence identity,preferably over a region of over a region of at least about 15, 20, 25,50, 75, 100, 125, 150 or more amino acids, to a polypeptide of SEQ IDNO:1 and 2) can either specifically bind to an antibody, e.g.,polyclonal antibody, raised against an epitope of EMP2 or inhibit theability of Chlamydia to enter a host cell expressing the EMP2polypeptide of SEQ ID NO:1 or inhibit the infectivity of Chlamydia. Insome embodiments, the EMP2 polypeptide is a fragment comprising,consisting of, or consisting essentially of the sequence of EMP2 fromposition 16 to 64, 20 to 60, 20 to 50, 20 to 40, or 30 to 64 or 40 to 64of SEQ ID NO:1. In some embodiments, the EMP2 polypeptide is a fragmentcomprising, consisting of, or consisting essentially of the sequence ofEMP2 from position 60 to 100, 80 to 150, 100 to 150, 110 to 140, 120 to140, 50 to 150, or 100 to 160 of SEQ ID NO:1. In some embodiments, theEMP2 fragment comprises an epitope recognized by an anti-EMP2 antibody.In some embodiments of the invention's first aspect, the epitoperecognized by an anti-EMP2 antibody inhibits the ability of Chlamydia toenter or bind a host cell expressing EMP2. In some embodiments of any ofthe above, the EMP2 fragment may be from 15 to 25, 15 to 40, 25 to 50,50 to 100 amino acids long, or longer. In some embodiments, for eitheraspect, the EMP2 polypeptide is a polypeptide which binds a diabodyhaving the KS49 or KS83 heavy and light chain sequences as disclosedherein.

An EMP2 polypeptide according to the invention may be a conservativelymodified variant of a polypeptide of SEQ ID NO:1. Accordingly, in someembodiments of the above, the EMP polypeptide consists of the sequenceof EMP2 of SEQ ID NO:1 or a fragment thereof. The fragment may be from15 to 25, 15 to 40, 25 to 50, 50 to 100 amino acids long, or longer. Thefragment may correspond to that of EMP2 from position 16 to 64 of SEQ IDNO:1. In other embodiments, the EMP2 polypeptide or fragment comprises asequence of EMP2 of SEQ ID NO:1 or SEQ ID NO:2 having from 1, 2, 3, 4,or 5 conservative amino acid modifications or 1, 2, 3, 4, or 5substitutions with a artificial chemical mimetic of the correspondingnaturally occurring amino acid. The fragment may be from 15 to 25, 15 to40, 25 to 50, 50 to 100 amino acids long, or longer. In some otherembodiments still, the EMP2 polypeptide sequence can be that of a mammalincluding, but not limited to, primate, e.g., human; rodent, e.g., rat,mouse, hamster; cow, pig, horse, sheep. The proteins of the inventioninclude both naturally occurring or recombinant molecules. In someembodiments, the amino acids of the EMP2 polypeptide are all naturallyoccurring amino acids as set forth below. In other embodiments, one ormore amino acids may be substituted by an artificial chemical mimetic ofa corresponding naturally occurring amino acids.

The terms “polypeptide,” “peptide” and “protein” are usedinterchangeably herein to refer to a polymer of amino acid residues. Theterms apply to amino acid polymers in which one or more amino acidresidue is an artificial chemical mimetic of a corresponding naturallyoccurring amino acid, as well as to naturally occurring amino acidpolymers and non-naturally occurring amino acid polymer. Methods forobtaining (e.g., producing, isolating, purifying, synthesizing, andrecombinantly manufacturing) polypeptides are well known to one ofordinary skill in the art.

The term “amino acid” refers to naturally occurring and synthetic aminoacids, as well as amino acid analogs and amino acid mimetics thatfunction in a manner similar to the naturally occurring amino acids.Naturally occurring amino acids are those encoded by the genetic code,as well as those amino acids that are later modified, e.g.,hydroxyproline, γ-carboxyglutamate, and O-phosphoserine Amino acidanalogs refers to compounds that have the same basic chemical structureas a naturally occurring amino acid, i.e., an a carbon that is bound toa hydrogen, a carboxyl group, an amino group, and an R group, e.g.,homoserine, norleucine, methionine sulfoxide, methionine methylsulfonium. Such analogs have modified R groups (e.g., norleucine) ormodified peptide backbones, but retain the same basic chemical structureas a naturally occurring amino acid Amino acid mimetics refers tochemical compounds that have a structure that is different from thegeneral chemical structure of an amino acid, but that functions in amanner similar to a naturally occurring amino acid.

Amino acids may be referred to herein by either their commonly knownthree letter symbols or by the one-letter symbols recommended by theIUPAC-IUB Biochemical Nomenclature Commission. Nucleotides, likewise,may be referred to by their commonly accepted single-letter codes.

As to “conservatively modified variants” of amino acid sequences, one ofskill will recognize that individual substitutions, deletions oradditions to a nucleic acid, peptide, polypeptide, or protein sequencewhich alters, adds or deletes a single amino acid or a small percentageof amino acids in the encoded sequence is a “conservatively modifiedvariant” where the alteration results in the substitution of an aminoacid with a chemically similar amino acid. Conservative substitutiontables providing functionally similar amino acids are well known in theart. Such conservatively modified variants are in addition to and do notexclude polymorphic variants, interspecies homologs, and alleles of theinvention.

The following eight groups each contain amino acids that areconservative substitutions for one another: 1) Alanine (A), Glycine (G);2) Aspartic acid (D), Glutamic acid (E); 3) Asparagine (N), Glutamine(Q); 4) Arginine (R), Lysine (K); 5) Isoleucine (I), Leucine (L),Methionine (M), Valine (V); 6) Phenylalanine (F), Tyrosine (Y),Tryptophan (W); 7) Serine (S), Threonine (T); and 8) Cysteine (C),Methionine (M) (see, e.g., Creighton, Proteins (1984)).

An “anti-EMP2 antibody” or “EMP2 antibody” according to the invention isan antibody which can bind to the EMP2 polypeptide of SEQ ID NO:1. Inthe first aspect of the invention, the antibodies according can act toinhibit the ability of Chlamydia to enter a host cell or causeinfection. Without being wed to theory, it is believed that theantibodies act to inhibit the ability of Chlamydia to enter the hostcell or cause an infection by reducing the availability of the host'sendogenous EMP2 for interacting or binding with Chlamydia. Theantibodies for use according to the invention in either aspect include,but are not limited to, recombinant antibodies, polyclonal antibodies,monoclonal antibodies, chimeric antibodies, human monoclonal antibodies,humanized or primatized monoclonal antibodies, and antibody fragments.The antibodies preferably bind to an external loop sequence of EMP2. Insome embodiments, the antibodies bind to a polypeptide having thesequence of SEQ ID NO:2.

“Antibody” refers to a polypeptide comprising a framework region from animmunoglobulin gene or fragments thereof that specifically binds andrecognizes an antigen. The recognized immunoglobulin genes include thekappa, lambda, alpha, gamma, delta, epsilon, and mu constant regiongenes, as well as the myriad immunoglobulin variable region genes. Lightchains are classified as either kappa or lambda. Heavy chains areclassified as gamma, mu, alpha, delta, or epsilon, which in turn definethe immunoglobulin classes, IgG, IgM, IgA, IgD and IgE, respectively.Typically, the antigen-binding region of an antibody will be mostcritical in specificity and affinity of binding.

An exemplary immunoglobulin (antibody) structural unit comprises atetramer. Each tetramer is composed of two identical pairs ofpolypeptide chains, each pair having one “light” (about 25 kD) and one“heavy” chain (about 50-70 kD). The N-terminus of each chain defines avariable region of about 100 to 110 or more amino acids primarilyresponsible for antigen recognition. The terms variable light chain(V_(L)) and variable heavy chain (V_(H)) refer to these light and heavychains respectively.

Antibodies exist, e.g., as intact immunoglobulins or as a number ofwell-characterized fragments produced by digestion with variouspeptidases. Thus, for example, pepsin digests an antibody below thedisulfide linkages in the hinge region to produce F(ab)′₂, a dimer ofFab which itself is a light chain joined to V_(H)—C_(H)1 by a disulfidebond. The F(ab)′₂ may be reduced under mild conditions to break thedisulfide linkage in the hinge region, thereby converting the F(ab)′₂dimer into an Fab′ monomer. The Fab′ monomer is essentially Fab withpart of the hinge region (see Fundamental Immunology (Paul ed., 3d ed.1993). While various antibody fragments are defined in terms of thedigestion of an intact antibody, one of skill will appreciate that suchfragments may be synthesized de novo either chemically or by usingrecombinant DNA methodology. Thus, the term antibody, as used herein,also includes antibody fragments either produced by the modification ofwhole antibodies, or those synthesized de novo using recombinant DNAmethodologies (e.g., single chain Fv) or those identified using phagedisplay libraries (see, e.g., McCafferty et al., Nature 348:552-554(1990)).

Accordingly, in either aspect of the invention, the term antibody alsoembraces minibodies, diabodies, triabodies and the like. Diabodies aresmall bivalent biospecific antibody fragments with high avidity andspecificity. Their high signal to noise ratio is typically better due toa better specificity and fast blood clearance increasing their potentialfor diagnostic and therapeutic targeting of specific antigen (Sundaresanet al., J Nucl Med 44:1962-9 (2003). In addition, these antibodies areadvantageous because they can be engineered if necessary as differenttypes of antibody fragments ranging from a small single chain Fv to anintact IgG with varying isoforms (Wu & Senter, Nat. Biotechnol.23:1137-1146 (2005)). In some embodiments, the antibody fragment is partof a diabody. In some embodiments, in either aspect, the inventionprovides high avidity antibodies for use according to the invention.

The following human-origin antibody sequences encode for high-avidityantibodies specific for human (KS49, KS83) and mouse (KS83) EMP2 andhave antibody variable region heavy and light chains suitable for use ineither aspect of the invention:

KS49 heavy chain (SEQ ID NO: 6)M A Q V Q L V Q S G G G V V Q P G R S L R L S C A A S G F T F S S Y A M H W V R Q A P GK G L E W V A V I S Y D G S N K Y Y A D S V K G R F T I S R D N S K N T L Y L Q M N S L RA E D T A V Y Y C A R D R R G R K S A G I D Y W G Q G T L V T V S SKS49 light chain (SEQ ID NO: 7)D I Q M T Q S P S S L S A S V G D R V T I T C Q A S Q D I S N Y L N W Y Q Q K P G K A P KL L I Y A A S S L Q S G V P S R F S G S G S G T D F T L T I S S L Q P E D F A T Y Y C L Q D YN G W T F G Q G T K V D I K R A A A E Q K L I S E E D L N G A AKS83 heavy chain (SEQ ID NO: 8)M A Q V Q L V E S G G G L V Q P G G S L R L S C A A S G F T F S S Y A M H W V R Q A P GK G L E W V A V I S Y D G S N K Y Y A D S V K G R F T I S R D N S K N T L Y L Q M N S L RA E D T A V Y Y C A R T V G A T G A F D I W G Q G T M V T V S S SKS83 light chain (SEQ ID NO: 9)D I V M T Q S P S T V S A S V G D R V I I P C R A S Q S I G K W L A W Y Q Q K P G K A P K LL I Y K A S S L E G W V P S R F S G S G S G T E F S L T I S S L Q P D D S A T Y V C Q Q S HN F P P T F G G G T K L E I K R A A A E Q K L I S E E D L N G A A

Other diabodies for use according to either aspect of the inventioninclude KS41 and KS89:

KS41 (SEQ ID NO.: 10)M A Q V Q L V Q S G G G L V Q P G R S L R L S C A A S G F S F S E Y P M H W V RQ A P G R G L E S V A V I S Y D G E Y Q K Y A D S V K G R F T I S R D D S K S T VY L Q M N S L R P E D T A V Y Y C A R T I N N G M D V W G Q G T T V T V S SKS41 (SEQ ID NO.: 11)D I V M T Q S P S S L S A S V G D R V T I T C R A S Q G I R N D L G W Y Q Q K P GK A P E L L I Y G A S S L Q S G V P S R F S G S G S G T D F T L T I S S L Q P E D S AT Y Y C L Q D Y N G W T F G Q G T K L E I K R A A A E Q K L I S E E D L N G A AKS89 (SEQ ID NO.: 12)M A Q V Q L V Q S G G G L V Q P G R S L R L S C A A S G F S F S E Y P M H W V RQ A P G R G L E S V A V I S Y D G E Y Q K Y A D S V K G R F T I S R D D S K S T VY L Q M N S L R P E D T A V Y Y C A R T I N N G M D V W G Q G T T V T V S SKS89 (SEQ ID NO.: 13)D I V M T Q S P S S L S A S V G D R V T I T C R A S Q G I R N D L G W Y Q Q K P GK A P E L L I Y G A S S L Q S G V P S R F S G S G S G T D F T L T I S S L Q P E D S AT Y Y C L Q D Y N G W T F G Q G T K L E I K R A A A E Q K L I S E E D L N G A A

Anti-EMP-2 variable region sequences, used to encode proteins onbackbones including for native antibody, fragment antibody, or syntheticbackbones, can avidly bind EMP-2. Via this binding, these proteins canbe used for EMP-2 detection, and to block EMP-2 function. Expression ofthese variable region sequences on native antibody backbones, or as anscFv, triabody, diabody or minibody, labeled with radionuclide, areparticularly useful in the in vivo detection of EMP-2 bearing cells.Expression on these backbones or native antibody backbone are favorablefor blocking the function of EMP-2 and/or killing EMP-2 bearing cells(e.g. gynecologic tumors) in vivo.

In some embodiments, the present invention provides anti-EMP-2 sequencescomprising CDR regions of an antibody selected from KS49, KS83, KS41,and KS89, as shown in FIG. 24. The CDR regions provided by the inventionmay be used to construct an anti-EMP-2 binding protein, includingwithout limitation, an antibody, a scFv, a triabody, a diabody, aminibody, and the like. In a certain embodiment, an anti-EMP-2 bindingprotein of the invention will comprise at least one CDR region from anantibody selected from KS49, KS83, KS41, and KS89. Anti-EMP-2 bindingproteins may comprise, for example, a CDR-H1, a CDR-H2, a CDR-H3, aCDR-L1, a CDR-L2, a CDR-L3, or combinations thereof, from an antibodyprovided herein. In particular embodiments of the invention, ananti-EMP-2 binding protein may comprise all three CDR-H sequences of anantibody provided herein, all three CDR-L sequences of an antibodyprovided herein, or both. Anti-EMP2 CDR sequences may be used on anantibody backbone, or fragment thereof, and likewise may includehumanized antibodies, or antibodies containing humanized sequences.These antibodies may be used, for example, to detect EMP-2, to detectcells expressing EMP-2 in vivo, or to block EMP-2 function. In someembodiments, the CDR regions may be defined using the Kabat definition,the Chothia definition, the AbM definition, the contact definition, orany other suitable CDR numbering system.

In some embodiments, the CDRs are as follows:

CDR 1 Heavy (SEQ ID NO.: 14) SYAMH (49) (SEQ ID NO.: 14) SYAMH (83)(SEQ ID NO.: 15) EYPMH (41) (SEQ ID NO.: 15) EYPMH (89) CDR 2 Heavy(SEQ ID NO.: 16) VISYDGSNKYYADSVKG (49) (SEQ ID NO.: 16)VISYDGSNKYYADSVKG (83) (SEQ ID NO.: 17) VISYDGEYQKYADSVKG (41)(SEQ ID NO.: 17) VISYDGEYQKYADSVKG (89) CDR 3 Heavy (SEQ ID NO.: 39)DRRGRKSAGIDY (49) (SEQ ID NO.: 37) TVGATGAFDI (83) (SEQ ID NO.: 41)TINNGMDV (41) (SEQ ID NO.: 41) TINNGMDV (89) CDR 1 Light(SEQ ID NO.: 18) QASQDISNYLN (49) (SEQ ID NO.: 19) RASQSIGKWLA (83)(SEQ ID NO.: 20) RASQGIRNDLG (41) (SEQ ID NO.: 20) RASQGIRNDLG (89) CDR 2 Light (SEQ ID NO.: 21 AASSLQS (49) (SEQ ID NO.: 22) KASSLEG (83)(SEQ ID NO.: 23) GASSLQS (41) (SEQ ID NO.: 23) GASSLQS (89)  CDR 3 Light(SEQ ID NO.: 40) LQDYNGWT (49) (SEQ ID NO.: 38) QQSHNFPPT (83)(SEQ ID NO.: 40) LQDYNGWT (41) (SEQ ID NO.: 40) LQDYNGWT (89)Diabody Sequence (KS49)

Heavy chain, KS49 (SEQ ID NO.: 6)M A Q V Q L V Q S G G G V V Q P G R S L R L S C A A S G F T F S S Y A M H W V RQ A P G K G L E W V A V I S Y D G S N K Y Y A D S V K G R F T I S R D N S K N T LY L Q M N S L R A E D T A V Y Y C A R D R R G R K S A G I D Y W G Q G T L V T VS (SEQ ID NO.: 14) CDR1 SYAMH (SEQ ID NO.: 16) CDR2 VISYDGSNKYYADSVKGLight chain, KS49 (SEQ ID NO.: 7)D I Q M T Q S P S S L S A S V G D R V T I T C Q A S Q D I S N Y L N W Y Q Q K P GK A P K L L I Y A A S S L Q S G V P S R F S G S G S G T D F T L T I S S L Q P E D F AT Y Y C L Q D Y N G W T F G Q G T K V D I K R A A A E Q K L I S E E D L N G A A(SEQ ID NO.: 18) CDR1 QASQDISNYLN (SEQ ID NO.: 21) CDR2 AASSLQSDiabody Sequence (KS83)

Heavy chain, KS83 (SEQ NO.: 8)M A Q V Q L V E S G G G L V Q P G G S L R L S C A A S G F T F S S Y A M H W V RQ A P G K G L E W V A V I S Y D G S N K Y Y A D S V K G R F T I S R D N S K N T LY L Q M N S L R A E D T A V Y Y C A R T V G A T G A F D I W G Q G T M V T V S S(SEQ ID NO.: 14) CDR1 SYAMH (SEQ ID NO.: 16) CDR2 VISYDGSNKYYADSVKGLight Chain, KS83 (SEQ ID NO.: 9)D I V M T Q S P S T V S A S V G D R V I I P C R A S Q S I G K W L A W Y Q Q K P G KA P K L L I Y K A S S L E G W V P S R F S G S G S G T E F S L T I S S L Q P D D S A TY V C Q Q S H N F P P T F G G G T K L E I K R A A A E Q K L I S E E D L N G A A(SEQ ID NO.: 19) CDR1 RASQSIGKWLA (SEQ ID NO.: 22) CDR2 KASSLEGDiabody Sequence (KS41)

Heavy Chain, KS41 (SEQ ID NO.: 10)M A Q V Q L V Q S G G G L V Q P G R S L R L S C A A S G F S F S E Y P M H W V RQ A P G R G L E S V A V I S Y D G E Y Q K Y A D S V K G R F T I S R D D S K S T VY L Q M N S L R P E D T A V Y Y C A R T I N N G M D V W G Q G T T V T V S S(SEQ ID NO.: 15) CDR 1 EYPMH (SEQ ID NO.: 17) CDR 2 VISYDGEYQKYADSVKGLight Chain, KS41 (SEQ ID NO.: 11)D I V M T Q S P S S L S A S V G D R V T I T C R A S Q G I R N D L G W Y Q Q K P GK A P E L L I Y G A S S L Q S G V P S R F S G S G S G T D F T L T I S S L Q P E D S AT Y Y C L Q D Y N G W T F G Q G T K L E I K R A A A E Q K L I S E E D L N G A A(SEQ ID NO.: 20) CDR 1 RASQGIRNDLG (SEQ ID NO.: 23) CDR 2 GASSLQSDiabody Sequence (KS89)

Heavy Chain, KS89 (SEQ ID NO.: 12)M A Q V Q L V Q S G G G L V Q P G R S L R L S C A A S G F S F S E Y P Mt H W V RQ A P G R G L E S V A V I S Y D G E Y Q K Y A D S V K G R F T I S R D D S K S T VY L Q M N S L R P E D T A V Y Y C A R T I N N G M D V W G Q G T T V T V S S(SEQ ID NO.: 15) CDR1 EYPMH (SEQ ID NO.: 17) CDR2 VISYDGEYQKYADSVKGLight Chain, KS89 (SEQ ID NO.: 13)D I V Met T Q S P S S L S A S V G D R V T I T C R A S Q G I R N D L G W Y Q Q K P GK A P E L L I Y G A S S L Q S G V P S R F S G S G S G T D F T L T I S S L Q P E D S AT Y Y C L Q D Y N G W T F G Q G T K L E I K R A A A E Q K L I S E E D L N G A A(SEQ ID NO.: 20) CDR1 RASQGIRNDLG (SEQ ID NO.: 23) CDR2 GASSLQS

In some embodiments, the invention provides antibodies (e.g., diabodies,minibodies, triabodies) or fragments thereof having the CDRs of adiabody selected from KS49, KS83, KS41, and KS89. In some embodiments,these antibodies lack the polyhistine tag. In other embodiments, thediabodies possess the light and heavy chain of a KS49, KS83, KS41, orKS89 diabody. In still other embodiments, the antibodies aresubstantially identical in sequence to a diabody selected from the groupconsisting of KS49, KS83, KS41, and KS89 with or without thepolyhistidine tag. In still other embodiments, the antibodies aresubstantially identical in sequence to the light and heavy chainsequences of a diabody selected from the group consisting of KS49, KS83,KS41, and KS89. These identities can be 65%, 70%, 75%, 80%, 85%, 90%,and preferably 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98% or 99% or greateramino acid sequence identity. In some further embodiments of any of theabove, the antibodies comprise CDRs sequences identical to those of theKS49, KS83, KS41, or KS89 diabody.

Diabodies, first described by Hollinger et al., PNAS (USA) 90(14):6444-6448 (1993), may be constructed using heavy and light chainsdisclosed herein, as well as by using individual CDR regions disclosedherein. Typically, diabody fragments comprise a heavy chain variabledomain (V_(H)) connected to a light chain variable domain (V_(L)) by alinker which is too short to allow pairing between the two domains onthe same chain. Accordingly, the V_(H) and V_(L) domains of one fragmentare forced to pair with the complementary V_(H) and V_(L) domains ofanother fragment, thereby forming two antigen-binding sites. Triabodiescan be similarly constructed with three antigen-binding sites. An Fvfragment contains a complete antigen-binding site which includes a V_(L)domain and a V_(H) domain held together by non-covalent interactions. Fvfragments embraced by the present invention also include constructs inwhich the V_(H) and V_(L) domains are crosslinked throughglutaraldehyde, intermolecular disulfides, or other linkers. Thevariable domains of the heavy and light chains can be fused together toform a single chain variable fragment (scFv), which retains the originalspecificity of the parent immunoglobulin. Single chain Fv (scFv) dimers,first described by Gruber et al., J. Immunol. 152(12):5368-74 (1994),may be constructed using heavy and light chains disclosed herein, aswell as by using individual CDR regions disclosed herein. Manytechniques known in the art can be used to prepare the specific bindingconstructs of the present invention (see, U.S. Patent ApplicationPublication No. 20070196274 and U.S. Patent Application Publication No.20050163782, which are each herein incorporated by reference in theirentireties for all purposes, particularly with respect to minibody anddiabody design).

Bispecific antibodies can be generated by chemical cross-linking or bythe hybrid hybridoma technology. Alternatively, bispecific antibodymolecules can be produced by recombinant techniques (see: bispecificantibodies). Dimerization can be promoted by reducing the length of thelinker joining the VH and the VL domain from about 15 amino acids,routinely used to produce scFv fragments, to about 5 amino acids. Theselinkers favor intrachain assembly of the VH and VL domains. A suitableshort linker is SGGGS (SEQ ID NO.: 24), but other linkers can be used.Thus, two fragments assemble into a dimeric molecule. Further reductionof the linker length to 0-2 amino acids can generate trimeric(triabodies) or tetrameric (tetrabodies) molecules.

Accordingly, this invention for the first time identifies the sequenceof recombinant antibodies, thereby permitting production of recombinantanti-EMP2 on desirable backbones, and in therapeutically anddiagnostically useful amounts. The KS83 and KS49 recombinant sequenceshave been constructed as in scFv, diabody, and native antibody formats.Sufficient protein amounts and purity have been achieved to documentbinding specificity in vitro. Cytolytic and tumor-ablative function ofhuman ovarian, endometrial, and glioblastoma cell lines have beendemonstrated in vitro and in vivo. The sequences are also useful whenincorporated onto a suitable backbone in producing recombinant anti-EMP2proteins (scFv, triabody, diabody, minibody, and native antibodyformats) for imaging or in vivo therapy.

For preparation of antibodies, e.g., recombinant, monoclonal, orpolyclonal antibodies, many techniques known in the art can be used(see, e.g., Kohler & Milstein, Nature 256:495-497 (1975); Kozbor et al.,Immunology Today 4:72 (1983); Cole et al., in Monoclonal Antibodies andCancer Therapy, Alan R. Liss, Inc., pp. 77-96 (1985); Coligan, CurrentProtocols in Immunology (1991); Harlow & Lane, Antibodies, A LaboratoryManual (1988); and Goding, Monoclonal Antibodies: Principles andPractice (2d ed. 1986)). The genes encoding the heavy and light chainsof an antibody of interest can be cloned from a cell, e.g., the genesencoding a monoclonal antibody can be cloned from a hybridoma and usedto produce a recombinant monoclonal antibody. Gene libraries encodingheavy and light chains of monoclonal antibodies can also be made fromhybridoma or plasma cells. Random combinations of the heavy and lightchain gene products generate a large pool of antibodies with differentantigenic specificity (see, e.g., Kuby, Immunology (3^(rd) ed. 1997)).Techniques for the production of single chain antibodies or recombinantantibodies (U.S. Pat. No. 4,946,778, U.S. Pat. No. 4,816,567) can beadapted to produce antibodies to polypeptides of this invention. Also,transgenic mice, or other organisms such as other mammals, may be usedto express humanized or human antibodies (see, e.g., U.S. Pat. Nos.5,545,807; 5,545,806; 5,569,825; 5,625,126; 5,633,425; 5,661,016, Markset al., Bio/Technology 10:779-783 (1992); Lonberg et al., Nature368:856-859 (1994); Morrison, Nature 368:812-13 (1994); Fishwild et al.,Nature Biotechnology 14:845-51 (1996); Neuberger, Nature Biotechnology14:826 (1996); and Lonberg & Huszar, Intern. Rev. Immunol. 13:65-93(1995)). Alternatively, phage display technology can be used to identifyantibodies and heteromeric Fab fragments that specifically bind toselected antigens (see, e.g., McCafferty et al., Nature 348:552-554(1990); Marks et al., Biotechnology 10:779-783 (1992)). Antibodies canalso be made bispecific, i.e., able to recognize two different antigens(see, e.g., WO 93/08829, Traunecker et al., EMBO J. 10:3655-3659 (1991);and Suresh et al., Methods in Enzymology 121:210 (1986)). Antibodies canalso be heteroconjugates, e.g., two covalently joined antibodies, orimmunotoxins (see, e.g., U.S. Pat. No. 4,676,980, WO 91/00360; WO92/200373; and EP 03089).

Methods for humanizing or primatizing non-human antibodies are wellknown in the art. Generally, a humanized antibody has one or more aminoacid residues introduced into it from a source which is non-human. Thesenon-human amino acid residues are often referred to as import residues,which are typically taken from an import variable domain. Humanizationcan be essentially performed following the method of Winter andco-workers (see, e.g., Jones et al., Nature 321:522-525 (1986);Riechmann et al., Nature 332:323-327 (1988); Verhoeyen et al., Science239:1534-1536 (1988) and Presta, Curr. Op. Struct. Biol. 2:593-596(1992)), by substituting rodent CDRs or CDR sequences for thecorresponding sequences of a human antibody. Accordingly, such humanizedantibodies are chimeric antibodies (U.S. Pat. No. 4,816,567), whereinsubstantially less than an intact human variable domain has beensubstituted by the corresponding sequence from a non-human species. Inpractice, humanized antibodies are typically human antibodies in whichsome CDR residues and possibly some FR residues are substituted byresidues from analogous sites in rodent antibodies.

A “chimeric antibody” is an antibody molecule in which (a) the constantregion, or a portion thereof, is altered, replaced or exchanged so thatthe antigen binding site (variable region) is linked to a constantregion of a different or altered class, effector function and/orspecies, or an entirely different molecule which confers new propertiesto the chimeric antibody, e.g., an enzyme, toxin, hormone, growthfactor, drug, etc.; or (b) the variable region, or a portion thereof, isaltered, replaced or exchanged with a variable region having a differentor altered antigen specificity.

The phrase “specifically (or selectively) binds” to an antibody or“specifically (or selectively) immunoreactive with,” when referring to aprotein or peptide, refers to a binding reaction that is determinativeof the presence of the protein, often in a heterogeneous population ofproteins and other biologics. Thus, under designated immunoassayconditions, the specified antibodies bind to a particular protein atleast two times the background and more typically more than 10 to 100times background. Specific binding to an antibody under such conditionsrequires an antibody that is selected for its specificity for aparticular protein. For example, polyclonal antibodies can be selectedto obtain only those polyclonal antibodies that are specificallyimmunoreactive with the selected antigen and not with other proteins.This selection may be achieved by subtracting out antibodies thatcross-react with other molecules. A variety of immunoassay formats maybe used to select antibodies specifically immunoreactive with aparticular protein. For example, solid-phase ELISA immunoassays areroutinely used to select antibodies specifically immunoreactive with aprotein (see, e.g., Harlow & Lane, Using Antibodies, A Laboratory Manual(1998) for a description of immunoassay formats and conditions that canbe used to determine specific immunoreactivity).

For example, rabbit polyclonal antibodies to EMP2 are known in the art(see, Wang et al., Blood 97:3890-3895 (2001)). Such antibodies may beobtained using glutathione-S-transferase-EMP2 fusion proteins. Rabbitantibodies can be generated against the first extracellular region ofthe gene (from amino acid 16 to 64) constructed as aglutathione-S-transferase (GST)-EMP2 fusion protein. The EMP2 peptidecan be cloned by PCR using the following primers:CGCGGATCCTCTACCATTGACAATGCCTGG (SEQ ID NO.: 25) (forward; BamHIunderlined); CCGGAATTCTTACGCCTGCATCACAGAATAACC (SEQ ID NO.: 26)(reverse, EcoRI underlined). The PCR product can be directionally clonedinto the BamHI and EcoRI sites of the pGEX-4T-1 vector that contains GSTgene (Pharmacia). The EMP2 fragment is cloned in frame with the GST tocreate a fusion protein. The insert can be confirmed by sequencing. TheGST fusion protein can be produced as previously described (see, Smith DB et al., Gene 67:31-40 (1988)). Bacteria in log phase (OD₆₀₀ 0.6 to0.9) can be induced for 2.5 to 3 hours at 37° C. with 1 mMisopropyl-1-thio-β-D-galactopyranoside. Bacteria are lysed, and thesoluble fraction loaded onto a glutathione-Sepharose column (Pierce,Rockford, Ill.). The columns are washed with 10 bed volumes ofphosphate-buffered saline (PBS)/EDTA. The fusion protein elutes from thecolumn using 20 mM reduced glutathione (Sigma, St Louis, Mo.) in 50 mMTris-Cl, pH 8.0. For antibody preparation, rabbits are immunized twicewith the GST-EMP2 fusion protein, and serum is collected, starting 2weeks after the last immunization (Research Genetics, Huntsville, Ala.).

Example 6 exemplifies an approach for obtaining fully human monoclonalantibodies to EMP2. These antibodies can be produced using recombinantphage-display technology from a human antibody phage-display genelibrary. Such monoclonal antibodies to human EMP2 can be used fordiagnostic purposes, in cancer therapy, and as EMP2 Chlamydialinhibitors for prevention or treatment of Chlamydia infection.Monoclonal antibodies to mouse EMP2 can be similarly prepared for use invalidating the therapeutic strategy in pre-clinical mouse models ofcancer or Chlamydia infection in vivo.

In some embodiments, the invention provides an “EMP2 siRNA” for use inpreventing, treating or inhibiting a Chlamydia infection or a canceroverexpressing EMP2. In this embodiment, the siRNA has a sequence whichis complementary to that of SEQ ID NO:3 and is capable of reducing theexpression of EMP2 in a target cell of the host.

An “siRNA” or “RNAi” refers to a nucleic acid that forms a doublestranded RNA, which double stranded RNA has the ability to reduce orinhibit expression of a gene or target gene when the siRNA expressed inthe same cell as the gene or target gene. “siRNA” or “RNAi” thus refersto the double stranded RNA formed by the complementary strands. Thecomplementary portions of the siRNA that hybridize to form the doublestranded molecule typically have substantial or complete identity. Inone embodiment, an siRNA refers to a nucleic acid that has substantialor complete identity to a target gene and forms a double stranded siRNA.Typically, the siRNA is at least about 15-50 nucleotides in length(e.g., each complementary sequence of the double stranded siRNA is 15-50nucleotides in length, and the double stranded siRNA is about 15-50 basepairs in length, preferable about preferably about 20-30 basenucleotides, preferably about 20-25 or about 24-29 nucleotides inlength, e.g., 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, or 30 nucleotidesin length.

The design and making of siRNA molecules and vectors are well known tothose of ordinary skill in the art. For instance, an efficient processfor designing a suitable siRNA is to start at the AUG start codon of themRNA transcript (e.g., see, FIG. 5) and scan for AA dinucleotidesequences (see, Elbashir et al., EMBO J 20:6877-6888 (2001)). Each AAand the 3′ adjacent nucleotides are potential siRNA target sites. Thelength of the adjacent site sequence will determine the length of thesiRNA. For instance, 19 adjacent sites would give a 21 Nucleotide longsiRNA siRNAs with 3′ overhanging UU dinucleotides are often the mosteffective. This approach is also compatible with using RNA pol III totranscribe hairpin siRNAs. RNA pol III terminates transcription at 4-6nucleotide poly(T) tracts to create RNA molecules having a short poly(U)tail. However, siRNAs with other 3′ terminal dinucleotide overhangs canalso effectively induce RNAi and the sequence may be empiricallyselected. For selectivity, target sequences with more than 16-17contiguous base pairs of homology to other coding sequences can beavoided by conducting a BLAST search (see, www.ncbi.nlm.nih.gov/BLAST).

The siRNA can be administered directly or an siRNA expression vectorscan be used to induce RNAi. A vector can have inserted two invertedrepeats separated by a short spacer sequence and ending with a string ofT's which serve to terminate transcription. The expressed RNA transcriptis predicted to fold into a short hairpin siRNA. The selection of siRNAtarget sequence, the length of the inverted repeats that encode the stemof a putative hairpin, the order of the inverted repeats, the length andcomposition of the spacer sequence that encodes the loop of the hairpin,and the presence or absence of 5′-overhangs, can vary. A preferred orderof the siRNA expression cassette is sense strand, short spacer, andantisense strand. Hairpin siRNAs with these various stem lengths (e.g.,15 to 30) are suitable. The length of the loops linking sense andantisense strands of the hairpin siRNA can have varying lengths (e.g., 3to 9 nucleotides, or longer). The vectors may contain promoters andexpression enhancers or other regulatory elements which are operablylinked to the nucleotide sequence encoding the siRNA.

The expression “control sequences” refers to DNA sequences necessary forthe expression of an operably linked coding sequence in a particularhost organism. The control sequences that are suitable for prokaryotes,for example, include a promoter, optionally an operator sequence, and aribosome binding site. Eukaryotic cells are known to utilize promoters,polyadenylation signals, and enhancers. These control elements may bedesigned to allow the clinician to turn off or on the expression of thegene by adding or controlling external factors to which the regulatoryelements are responsive.

In some embodiments, the EMP2 inhibitor is an EMP2 ribozyme which caninhibit the expression of EMP2 when present in a cell. Ribozymes areenzymatic RNA molecules capable of catalysing the specific cleavage ofRNA. The mechanism of ribozyme action involves sequence specifichybridisation of the ribozyme molecule to complementary target RNA,followed by an endonucleolytic cleavage. Within the scope of theinvention are engineered hammerhead motif ribozyme molecules thatspecifically and efficiently catalyse endonucleolytic cleavage of EMP2mRNA, including particularly the mRNA of SEQ ID NO:3. Specific ribozymecleavage sites within any potential RNA target are initially identifiedby scanning the target molecule for ribozyme cleavage sites, whichinclude the following sequences, GUA, GUU and GUC. Once identified,short RNA sequences of between 15 and 20 ribonucleotides correspondingto the region of the target gene containing the cleavage site may beevaluated for predicted structural features such as secondary structurethat may render the oligonucleotide sequence unsuitable. Both anti-senseRNA and DNA molecules and ribozymes of the invention may be prepared byany method known in the art for the synthesis of RNA molecules. Theseinclude techniques for chemically synthesizing oligodeoxyribonucleotideswell known in the art such as for example solid phase phosphoramiditechemical synthesis. Alternatively, RNA molecules may be generated by invitro and in vivo transcription of DNA sequences encoding the antisenseRNA molecule. Such DNA sequences may be incorporated into a wide varietyof vectors, which incorporate suitable RNA polymerase promoters such asthe T7 or SP6 polymerase promoters. Methods of making ribozymes are wellknown in the art (see, for instance, U.S. Patent Application PublicationNo. 20060062785).

Construction of suitable vectors for the EMP2 siRNA or EMP2 Ribozymescontaining the desired EMP2 siRNA or EMP2 Ribozyme sequences and controlsequences employs standard ligation and restriction techniques, whichare well understood in the art (see Maniatis et al., in MolecularCloning: A Laboratory Manual, Cold Spring Harbor Laboratory, New York(1982)). Isolated plasmids, DNA sequences, or synthesizedoligonucleotides are cleaved, tailored, and religated in the formdesired.

Nucleic acid is “operably linked” when it is placed into a functionalrelationship with another nucleic acid sequence. For example, DNA for apresequence or secretory leader is operably linked to DNA for apolypeptide if it is expressed as a preprotein that participates in thesecretion of the polypeptide; a promoter or enhancer is operably linkedto a coding sequence if it affects the transcription of the sequence; ora ribosome binding site is operably linked to a coding sequence if it ispositioned so as to facilitate translation. Generally, “operably linked”means that the DNA sequences being linked are near each other, and, inthe case of a secretory leader, contiguous and in reading phase.However, enhancers do not have to be contiguous. Linking is accomplishedby ligation at convenient restriction sites. If such sites do not exist,the synthetic oligonucleotide adaptors or linkers are used in accordancewith conventional practice.

“Conservatively modified variants” applies to both amino acid andnucleic acid sequences. With respect to particular nucleic acidsequences, conservatively modified variants refers to those nucleicacids which encode identical or essentially identical amino acidsequences, or where the nucleic acid does not encode an amino acidsequence, to essentially identical sequences. Because of the degeneracyof the genetic code, a large number of functionally identical nucleicacids encode any given protein. For instance, the codons GCA, GCC, GCGand GCU all encode the amino acid alanine. Thus, at every position wherean alanine is specified by a codon, the codon can be altered to any ofthe corresponding codons described without altering the encodedpolypeptide. Such nucleic acid variations are “silent variations,” whichare one species of conservatively modified variations. Every nucleicacid sequence herein which encodes a polypeptide also describes everypossible silent variation of the nucleic acid. One of skill willrecognize that each codon in a nucleic acid (except AUG, which isordinarily the only codon for methionine, and TGG, which is ordinarilythe only codon for tryptophan) can be modified to yield a functionallyidentical molecule. Accordingly, each silent variation of a nucleic acidwhich encodes a polypeptide is implicit in each described sequence withrespect to the expression product, but not with respect to actual probesequences.

The terms “identical” or percent “identity,” in the context of two ormore nucleic acids or polypeptide sequences, including EMP2 siRNA andEMP2 polypeptides, refer to two or more sequences or subsequences thatare the same or have a specified percentage of amino acid residues ornucleotides that are the same (i.e., about 60% identity, preferably 65%,70%, 75%, 80%, 85%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99%, orhigher identity over a specified region, when compared and aligned formaximum correspondence over a comparison window or designated region) asmeasured using a BLAST or BLAST 2.0 sequence comparison algorithms withdefault parameters described below, or by manual alignment and visualinspection (see, e.g., NCBI web sitehttp://www.ncbi.nlm.nih.gov/BLAST/or the like). Such sequences are thensaid to be “substantially identical.” This definition also refers to, ormay be applied to, the compliment of a test sequence. The definitionalso includes sequences that have deletions and/or additions, as well asthose that have substitutions. As described below, the preferredalgorithms can account for gaps and the like. Preferably, identityexists over a region that is at least about 25 amino acids ornucleotides in length, or more preferably over a region that is 50-100amino acids or nucleotides in length.

For sequence comparison, typically one sequence acts as a referencesequence, to which test sequences are compared. When using a sequencecomparison algorithm, test and reference sequences are entered into acomputer, subsequence coordinates are designated, if necessary, andsequence algorithm program parameters are designated. Preferably,default program parameters can be used, or alternative parameters can bedesignated. The sequence comparison algorithm then calculates thepercent sequence identities for the test sequences relative to thereference sequence, based on the program parameters.

A “comparison window,” as used herein, includes reference to a segmentof any one of the number of contiguous positions selected from the groupconsisting of from 20 to the full length of the reference sequence,usually about 25 to 100, or 50 to about 150, more usually about 100 toabout 150 in which a sequence may be compared to a reference sequence ofthe same number of contiguous positions after the two sequences areoptimally aligned. Methods of alignment of sequences for comparison arewell-known in the art. Optimal alignment of sequences for comparison canbe conducted, e.g., by the local homology algorithm of Smith & Waterman,Adv. Appl. Math. 2:482 (1981), by the homology alignment algorithm ofNeedleman & Wunsch, J. Mol. Biol. 48:443 (1970), by the search forsimilarity method of Pearson & Lipman, Proc. Nat'l. Acad. Sci. USA85:2444 (1988), by computerized implementations of these algorithms(GAP, BESTFIT, FASTA, and TFASTA in the Wisconsin Genetics SoftwarePackage, Genetics Computer Group, 575 Science Dr., Madison, Wis.), or bymanual alignment and visual inspection (see, e.g., Current Protocols inMolecular Biology (Ausubel et al., eds. 1995 supplement)).

A preferred example of algorithm that is suitable for determiningpercent sequence identity and sequence similarity are the BLAST andBLAST 2.0 algorithms, which are described in Altschul et al., Nuc. AcidsRes. 25:3389-3402 (1977) and Altschul et al., J. Mol. Biol. 215:403-410(1990), respectively. BLAST and BLAST 2.0 are used, with the parametersdescribed herein, to determine percent sequence identity for the nucleicacids and proteins of the invention. Software for performing BLASTanalyses is publicly available through the National Center forBiotechnology Information (http://www.ncbi.nlm.nih.gov/). This algorithminvolves first identifying high scoring sequence pairs (HSPs) byidentifying short words of length W in the query sequence, which eithermatch or satisfy some positive-valued threshold score T when alignedwith a word of the same length in a database sequence. T is referred toas the neighborhood word score threshold (Altschul et al., supra). Theseinitial neighborhood word hits act as seeds for initiating searches tofind longer HSPs containing them. The word hits are extended in bothdirections along each sequence for as far as the cumulative alignmentscore can be increased. Cumulative scores are calculated using, fornucleotide sequences, the parameters M (reward score for a pair ofmatching residues; always >0) and N (penalty score for mismatchingresidues; always <0). For amino acid sequences, a scoring matrix is usedto calculate the cumulative score. Extension of the word hits in eachdirection are halted when: the cumulative alignment score falls off bythe quantity X from its maximum achieved value; the cumulative scoregoes to zero or below, due to the accumulation of one or morenegative-scoring residue alignments; or the end of either sequence isreached. The BLAST algorithm parameters W, T, and X determine thesensitivity and speed of the alignment. The BLASTN program (fornucleotide sequences) uses as defaults a wordlength (W) of 11, anexpectation (E) of 10, M=5, N=−4 and a comparison of both strands. Foramino acid sequences, the BLASTP program uses as defaults a wordlengthof 3, and expectation (E) of 10, and the BLOSUM62 scoring matrix (seeHenikoff & Henikoff, Proc. Natl. Acad. Sci. USA 89:10915 (1989))alignments (B) of 50, expectation (E) of 10, M=5, N=−4, and a comparisonof both strands.

“Nucleic acid” refers to deoxyribonucleotides or ribonucleotides andpolymers thereof in either single- or double-stranded form, andcomplements thereof. The term encompasses nucleic acids containing knownnucleotide analogs or modified backbone residues or linkages, which aresynthetic, naturally occurring, and non-naturally occurring, which havesimilar binding properties as the reference nucleic acid, and which aremetabolized in a manner similar to the reference nucleotides. Examplesof such analogs include, without limitation, phosphorothioates,phosphoramidates, methyl phosphonates, chiral-methyl phosphonates,2-O-methyl ribonucleotides, peptide-nucleic acids (PNAs).

Unless otherwise indicated, a particular nucleic acid sequence alsoimplicitly encompasses conservatively modified variants thereof (e.g.,degenerate codon substitutions) and complementary sequences, as well asthe sequence explicitly indicated. Specifically, degenerate codonsubstitutions may be achieved by generating sequences in which the thirdposition of one or more selected (or all) codons is substituted withmixed-base and/or deoxyinosine residues (Batzer et al., Nucleic AcidRes. 19:5081 (1991); Ohtsuka et al., J. Biol. Chem. 260:2605-2608(1985); Rossolini et al., Mol. Cell. Probes 8:91-98 (1994)). The termnucleic acid is used interchangeably with gene, cDNA, mRNA,oligonucleotide, and polynucleotide.

A particular nucleic acid sequence also implicitly encompasses “splicevariants.” Similarly, a particular protein encoded by a nucleic acidimplicitly encompasses any protein encoded by a splice variant of thatnucleic acid. “Splice variants,” as the name suggests, are products ofalternative splicing of a gene. After transcription, an initial nucleicacid transcript may be spliced such that different (alternate) nucleicacid splice products encode different polypeptides. Mechanisms for theproduction of splice variants vary, but include alternate splicing ofexons. Alternate polypeptides derived from the same nucleic acid byread-through transcription are also encompassed by this definition. Anyproducts of a splicing reaction, including recombinant forms of thesplice products, are included in this definition. An example ofpotassium channel splice variants is discussed in Leicher et al., J.Biol. Chem. 273(52):35095-35101 (1998).

The term “heterologous” when used with reference to portions of anucleic acid indicates that the nucleic acid comprises two or moresubsequences that are not found in the same relationship to each otherin nature. For instance, the nucleic acid is typically recombinantlyproduced, having two or more sequences from unrelated genes arranged tomake a new functional nucleic acid, e.g., a promoter from one source anda coding region from another source. Similarly, a heterologous proteinindicates that the protein comprises two or more subsequences that arenot found in the same relationship to each other in nature (e.g., afusion protein).

The phrase “stringent hybridization conditions” refers to conditionsunder which a probe will hybridize to its target subsequence, typicallyin a complex mixture of nucleic acids, but to no other sequences.Stringent conditions are sequence-dependent and will be different indifferent circumstances. Longer sequences hybridize specifically athigher temperatures. An extensive guide to the hybridization of nucleicacids is found in Tijssen, Techniques in Biochemistry and MolecularBiology—Hybridization with Nucleic Probes, “Overview of principles ofhybridization and the strategy of nucleic acid assays” (1993).Generally, stringent conditions are selected to be about 5-10° C. lowerthan the thermal melting point (T_(m)) for the specific sequence at adefined ionic strength pH. The T_(m) is the temperature (under definedionic strength, pH, and nucleic concentration) at which 50% of theprobes complementary to the target hybridize to the target sequence atequilibrium (as the target sequences are present in excess, at T_(m),50% of the probes are occupied at equilibrium). Stringent conditions mayalso be achieved with the addition of destabilizing agents such asformamide. For selective or specific hybridization, a positive signal isat least two times background, preferably 10 times backgroundhybridization. Exemplary stringent hybridization conditions can be asfollowing: 50% formamide, 5×SSC, and 1% SDS, incubating at 42° C., or,5×SSC, 1% SDS, incubating at 65° C., with wash in 0.2×SSC, and 0.1% SDSat 65° C.

Nucleic acids that do not hybridize to each other under stringentconditions are still substantially identical if the polypeptides whichthey encode are substantially identical. This occurs, for example, whena copy of a nucleic acid is created using the maximum codon degeneracypermitted by the genetic code. In such cases, the nucleic acidstypically hybridize under moderately stringent hybridization conditions.Exemplary “moderately stringent hybridization conditions” include ahybridization in a buffer of 40% formamide, 1 M NaCl, 1% SDS at 37° C.,and a wash in 1×SSC at 45° C. A positive hybridization is at least twicebackground. Those of ordinary skill will readily recognize thatalternative hybridization and wash conditions can be utilized to provideconditions of similar stringency. Additional guidelines for determininghybridization parameters are provided in numerous reference, e.g., andCurrent Protocols in Molecular Biology, ed. Ausubel, et al., John Wiley& Sons.

For PCR, a temperature of about 36° C. is typical for low stringencyamplification, although annealing temperatures may vary between about32° C. and 48° C. depending on primer length. For high stringency PCRamplification, a temperature of about 62° C. is typical, although highstringency annealing temperatures can range from about 50° C. to about65° C., depending on the primer length and specificity. Typical cycleconditions for both high and low stringency amplifications include adenaturation phase of 90° C.-95° C. for 30 sec-2 min., an annealingphase lasting 30 sec.-2 min., and an extension phase of about 72° C. for1-2 min. Protocols and guidelines for low and high stringencyamplification reactions are provided, e.g., in Innis et al. (1990) PCRProtocols, A Guide to Methods and Applications, Academic Press, Inc.N.Y.).

The EMP2 antibody or EMP2 polypeptide according to the invention canhave a label or detectable moiety attached thereto. A “label” or a“detectable moiety” is a composition detectable by spectroscopic,photochemical, biochemical, immunochemical, chemical, or other physicalmeans. For example, useful labels include ³²P, fluorescent dyes,electron-dense reagents, enzymes (e.g., as commonly used in an ELISA),biotin, digoxigenin, or haptens and proteins which can be madedetectable, e.g., by incorporating a radiolabel into the peptide or usedto detect antibodies specifically reactive with the peptide.

The term “recombinant” when used with reference, e.g., to a cell, ornucleic acid, protein, or vector, indicates that the cell, nucleic acid,protein or vector, has been modified by the introduction of aheterologous nucleic acid or protein or the alteration of a nativenucleic acid or protein, or that the cell is derived from a cell somodified. Thus, for example, recombinant cells express genes that arenot found within the native (non-recombinant) form of the cell orexpress native genes that are otherwise abnormally expressed, underexpressed or not expressed at all.

The term “test compound” or “candidate molecule” or “modulator” orgrammatical equivalents as used herein describes any molecule, eithernaturally occurring or synthetic, e.g., protein, polypeptide,oligopeptide (e.g., from about 5 to about 25 amino acids in length,preferably from about 10 to 20 or 12 to 18 amino acids in length,preferably 12, 15, or 18 amino acids in length), small organic molecule,polysaccharide, lipid, fatty acid, polynucleotide, RNAi,oligonucleotide, etc. The test compound can be in the form of a libraryof test compounds, such as a combinatorial or randomized library thatprovides a sufficient range of diversity. Test compounds are optionallylinked to a fusion partner, e.g., targeting compounds, rescue compounds,dimerization compounds, stabilizing compounds, addressable compounds,and other functional moieties. Conventionally, new chemical entitieswith useful properties are generated by identifying a test compound(called a “lead compound”) with some desirable property or activity,e.g., inhibiting activity, creating variants of the lead compound, andevaluating the property and activity of those variant compounds. Often,high throughput screening (HTS) methods are employed for such ananalysis.

A “small organic molecule” refers to an organic molecule, eithernaturally occurring or synthetic, that has a molecular weight of morethan about 50 Daltons and less than about 2500 Daltons, preferably lessthan about 2000 Daltons, preferably between about 100 to about 1000Daltons, more preferably between about 200 to about 500 Daltons.

“Determining the functional effect” refers to assaying for a compoundthat increases or decreases a parameter that is indirectly or directlyunder the influence of a polynucleotide or polypeptide for use accordingto the invention, e.g., measuring physical and chemical or phenotypiceffects. Such functional effects can be measured by any means known tothose skilled in the art, e.g., changes in spectroscopic (e.g.,fluorescence, absorbance, refractive index), hydrodynamic (e.g., shape),chromatographic, or solubility properties for the protein; measuringinducible markers or transcriptional activation of the protein;measuring binding activity or binding assays, e.g. binding toantibodies; measuring changes in ligand binding affinity; e.g., viachemiluminescence, fluorescence, colorimetric reactions, antibodybinding, inducible markers, and ligand binding assays.

Samples or assays for identifying a EMP2 inhibitors of the invention areconducted in the presence of the candidate inhibitor and then theresults are compared to control samples without the inhibitor to examinefor the desired activity or to determine the functional effect of thecandidate inhibitor. A positive reference control which is an agenthaving the desired activity may be used. In the case of EMP2polypeptides, the positive control agent may be EMP2 itself. Controlsamples (untreated with inhibitors) are assigned a relative of 100%.Inhibition is achieved when the activity value relative to the controlis about 80%, preferably 50%, more preferably 25 to 0%. Suitable methodsfor identifying inhibitors for use according to the invention are setforth in the Examples.

“Cancer” refers to human cancers and carcinomas, sarcomas,adenocarcinomas, lymphomas, leukemias, etc., including solid tumors andlymphoid cancers, kidney, breast, lung, kidney, bladder, colon, ovarian,prostate, pancreas, stomach, brain, head and neck, skin, uterine,testicular, esophagus, and liver cancer, lymphoma, includingnon-Hodgkin's and Hodgkin's lymphoma, leukemia, and multiple myeloma.“Urogenital cancer” refers to human cancers of urinary tract and genitaltissues, including but not limited to kidney, bladder, urinary tract,urethra, prostrate, penis, testicle, vulva, vagina, cervical and ovarytissues. The cancers to be detected, diagnosed or treated herein expressor overexpress EMP2. cancers which overexpress EMP2 include, but are notlimited to, endometrial cancer, ovarian cancer, glioblastoma, breastcancer, prostate cancer, testicular cancer, and myeloma.

In one embodiment of the invention's second aspect, a diagnostic orprognostic assay will be performed to determine whether the patient'scancer is characterized by overexpression of EMP2. Various assays fordetermining such amplification/overexpression are contemplated andinclude the immunohistochemistry, FISH and shed antigen assays, southernblotting, or PCR techniques. Moreover, the EMP2 overexpression oramplification may be evaluated using an in vivo diagnostic assay, e.g.by administering a molecule (such as an antibody) which binds themolecule to be detected and is tagged with a detectable label (e.g. aradioactive isotope) and externally scanning the patient forlocalization of the label. In some embodiments, the cancer to be treatedis not yet invasive, but overexpresses EMP2.

“Therapy resistant” cancers, tumor cells, and tumors refers to cancersthat have become resistant or refractory to either or bothapoptosis-mediated (e.g., through death receptor cell signaling, forexample, Fas ligand receptor, TRAIL receptors, TNF-R1, chemotherapeuticdrugs, radiation) and non-apoptosis mediated (e.g., toxic drugs,chemicals) cancer therapies, including chemotherapy, hormonal therapy,radiotherapy, and immunotherapy. The invention contemplates treatment ofboth types.

“Overexpression” refers to RNA or protein expression of EMP2 in a tissuethat is significantly higher that RNA or protein expression of in acontrol tissue sample. In one embodiment, the tissue sample isautologous. Cancerous test tissue samples associated with invasiveness,metastasis, hormone independent (e.g., androgen independence), orrefractoriness to treatment or an increased likelihood of same typicallyhave at least two fold higher expression of EMP2 mRNA or protein, oftenup to three, four, five, eight, ten or more fold higher expression ofEMP2 protein in comparison to cancer tissues from patients who are lesslikely to progress to metastasis or to normal (i.e., non-cancer) tissuesamples. Such differences may be readily apparent when viewing the bandsof gels with approximately similarly loaded with test and controlssamples. Prostate cancers expressing increased amounts of EMP2 are morelikely to become invasive, metastasize, or progress to treatmentrefractory cancer. Various cutoffs are pertinent for EMP2overexpression, since it is possible that a small percentage of EMP2positive cells in primary tumors may identify tumors with a high riskfor recurrence and metastasis. The terms “overexpress,” “overexpression”or “overexpressed” interchangeably refer to a gene that is transcribedor translated at a detectably greater level, usually in a cancer cell,in comparison to a normal cell of the same type. Overexpressiontherefore refers to both overexpression of protein and RNA (due toincreased transcription, post transcriptional processing, translation,post translational processing, altered stability, and altered proteindegradation), as well as local overexpression due to altered proteintraffic patterns (increased nuclear localization), and augmentedfunctional activity, e.g., as in an increased enzyme hydrolysis ofsubstrate. Overexpression can also be by 50%, 60%, 70%, 80%, 90% or more(2-fold, 3-fold, 4-fold) in comparison to a non-cancerous cell of thesame type. The overexpression may be based upon visually detectable orquantifiable differences observed using immunohistochemical methods todetect EMP2 protein or nucleic acid.

The terms “cancer that overexpresses EMP2” and “cancer associated withthe overexpression of EMP2” interchangeably refer to cancer cells ortissues that overexpress EMP2 in accordance with the above definition.

The terms “cancer-associated antigen” or “tumor-specific marker” or“tumor marker” interchangeably refers to a molecule (typically protein,carbohydrate or lipid) that is preferentially expressed in a cancer cellin comparison to a normal cell, and which is useful for the preferentialtargeting of a pharmacological agent to the cancer cell. A marker orantigen can be expressed on the cell surface or intracellularly.Oftentimes, a cancer-associated antigen is a molecule that isoverexpressed or stabilized with minimal degradation in a cancer cell incomparison to a normal cell, for instance, 2-fold overexpression, 3-foldoverexpression or more in comparison to a normal cell. Oftentimes, acancer-associated antigen is a molecule that is inappropriatelysynthesized in the cancer cell, for instance, a molecule that containsdeletions, additions or mutations in comparison to the moleculeexpressed on a normal cell. Oftentimes, a cancer-associated antigen willbe expressed exclusively in a cancer cell and not synthesized orexpressed in a normal cell.

Compositions.

When used for pharmaceutical purposes with regard to either aspect ofthe invention, the EMP2 inhibitors used according to the invention aretypically formulated in a suitable buffer, which can be anypharmaceutically acceptable buffer, such as phosphate buffered saline orsodium phosphate/sodium sulfate, Tris buffer, glycine buffer, sterilewater, and other buffers known to the ordinarily skilled artisan such asthose described by Good et al., Biochemistry 5:467 (1966). Thecompositions can additionally include a stabilizer, enhancer, or otherpharmaceutically acceptable carriers or vehicles. A pharmaceuticallyacceptable carrier can contain a physiologically acceptable compoundthat acts, for example, to stabilize the nucleic acids or polypeptidesof the invention and any associated vector. A physiologically acceptablecompound can include, for example, carbohydrates, such as glucose,sucrose or dextrans; antioxidants, such as ascorbic acid or glutathione;chelating agents; low molecular weight proteins or other stabilizers orexcipients. Other physiologically acceptable compounds include wettingagents, emulsifying agents, dispersing agents, or preservatives, whichare particularly useful for preventing the growth or action ofmicroorganisms. Various preservatives are well known and include, forexample, phenol and ascorbic acid. Examples of carriers, stabilizers, oradjuvants can be found in Remington's Pharmaceutical Sciences, MackPublishing Company, Philadelphia, Pa., 17th ed. (1985).

The pharmaceutical compositions according to the invention comprise atherapeutically effective amount of a EMP2 inhibitor (e.g.,EMP2-polypeptide, anti-EMP2 antibody, EMP2 si RNA, or EMP2 ribozyme)according to the invention and a pharmaceutically acceptable carrier. By“therapeutically effective dose or amount” herein is meant a dose thatproduces effects for which it is administered (e.g., treatment orprevention of a Chlamydia infection). The exact dose and formulationwill depend on the purpose of the treatment, and will be ascertainableby one skilled in the art using known techniques (see, e.g., Lieberman,Pharmaceutical Dosage Forms (vols. 1-3, 1992); Lloyd, The Art, Scienceand Technology of Pharmaceutical Compounding (1999); Remington: TheScience and Practice of Pharmacy, 20th Edition, Gennaro, Editor (2003),and Pickar, Dosage Calculations (1999)). The EMP2 Chlamydia inhibitor,if a salt, is formulated as a “pharmaceutically acceptable salt.”

A “pharmaceutically acceptable salt” or to include salts of the activecompounds which are prepared with relatively nontoxic acids or bases,according to the route of administration. When inhibitors of the presentinvention contain relatively acidic functionalities, base addition saltscan be obtained by contacting the neutral form of such compounds with asufficient amount of the desired base, either neat or in a suitableinert solvent. Examples of pharmaceutically acceptable base additionsalts include sodium, potassium, calcium, ammonium, organic amino, ormagnesium salt, or a similar salt. When compounds of the presentinvention contain relatively basic functionalities, acid addition saltscan be obtained by contacting the neutral form of such compounds with asufficient amount of the desired acid, either neat or in a suitableinert solvent. Examples of pharmaceutically acceptable acid additionsalts include those derived from inorganic acids like hydrochloric,hydrobromic, nitric, carbonic, monohydrogencarbonic, phosphoric,monohydrogenphosphoric, dihydrogenphosphoric, sulfuric,monohydrogensulfuric, hydriodic, or phosphorous acids and the like, aswell as the salts derived from relatively nontoxic organic acids likeacetic, propionic, isobutyric, maleic, malonic, benzoic, succinic,suberic, fumaric, lactic, mandelic, phthalic, benzenesulfonic,p-tolylsulfonic, citric, tartaric, methanesulfonic, and the like. Alsoincluded are salts of amino acids such as arginate and the like, andsalts of organic acids like glucuronic or galactunoric acids and thelike (see, e.g., Berge et al., Journal of Pharmaceutical Science 66:1-19(1977)). Certain specific compounds of the present invention containboth basic and acidic functionalities that allow the compounds to beconverted into either base or acid addition salts.

The neutral forms of the compounds may be regenerated by contacting thesalt with a base or acid and isolating the parent compound in theconventional manner. The parent form of the compound differs from thevarious salt forms in certain physical properties, such as solubility inpolar solvents, but otherwise the salts are equivalent to the parentform of the compound for the purposes of the present invention.

In addition to salt forms, the present invention provides compoundswhich are in a prodrug form. Prodrugs of the compounds described hereinare those compounds that readily undergo chemical changes underphysiological conditions to provide the compounds of the presentinvention. Additionally, prodrugs can be converted to the compounds ofthe present invention by chemical or biochemical methods in an ex vivoenvironment. For example, prodrugs can be slowly converted to thecompounds of the present invention when placed in a transdermal patchreservoir with a suitable enzyme or chemical reagent.

Certain compounds of the present invention can exist in unsolvated formsas well as solvated forms, including hydrated forms. In general, thesolvated forms are equivalent to unsolvated forms and are intended to beencompassed within the scope of the present invention. Certain compoundsof the present invention may exist in multiple crystalline or amorphousforms. In general, all physical forms are equivalent for the usescontemplated by the present invention and are intended to be within thescope of the present invention.

Aside from biopolymers such as nucleic acids and polypeptides, certaincompounds of the present invention possess asymmetric carbon atoms(optical centers) or double bonds; the racemates, diastereomers,geometric isomers and individual isomers are all intended to beencompassed within the scope of the present invention. In preferredembodiments, wherein the compound comprises amino acids or nucleicacids, the amino acids and nucleic acids are each the predominantnaturally occurring biological enantiomer.

The compositions for administration will commonly comprise an agent asdescribed herein dissolved in a pharmaceutically acceptable carrier,preferably an aqueous carrier. A variety of aqueous carriers can beused, e.g., buffered saline and the like. These solutions are sterileand generally free of undesirable matter. These compositions may besterilized by conventional, well known sterilization techniques. Thecompositions may contain pharmaceutically acceptable auxiliarysubstances as required to approximate physiological conditions such aspH adjusting and buffering agents, toxicity adjusting agents and thelike, for example, sodium acetate, sodium chloride, potassium chloride,calcium chloride, sodium lactate and the like. The concentration ofactive agent in these formulations can vary widely, and will be selectedprimarily based on fluid volumes, viscosities, body weight and the likein accordance with the particular mode of administration selected andthe patient's needs.

Suitable formulations for use in the present invention are found inRemington: The Science and Practice of Pharmacy, 20th Edition, Gennaro,Editor (2003) which is incorporated herein by reference. Moreover, for abrief review of methods for drug delivery, see, Langer, Science249:1527-1533 (1990), which is incorporated herein by reference. Thepharmaceutical compositions described herein can be manufactured in amanner that is known to those of skill in the art, i.e., by means ofconventional mixing, dissolving, granulating, dragee-making, levigating,emulsifying, encapsulating, entrapping or lyophilizing processes. Thefollowing methods and excipients are merely exemplary and are in no waylimiting.

For injection, the compounds of the present invention can be formulatedin aqueous solutions, preferably in physiologically compatible bufferssuch as Hanks's solution, Ringer's solution, or physiological salinebuffer. For transmucosal administration, penetrants appropriate to thebarrier to be permeated are used in the formulation. Such penetrants aregenerally known in the art.

For oral administration, the inhibitors for use according to theinvention can be formulated readily by combining with pharmaceuticallyacceptable carriers that are well known in the art. Such carriers enablethe compounds to be formulated as tablets, pills, dragees, capsules,emulsions, lipophilic and hydrophilic suspensions, liquids, gels,syrups, slurries, suspensions and the like, for oral ingestion by apatient to be treated. Pharmaceutical preparations for oral use can beobtained by mixing the compounds with a solid excipient, optionallygrinding a resulting mixture, and processing the mixture of granules,after adding suitable auxiliaries, if desired, to obtain tablets ordragee cores. Suitable excipients are, in particular, fillers such assugars, including lactose, sucrose, mannitol, or sorbitol; cellulosepreparations such as, for example, maize starch, wheat starch, ricestarch, potato starch, gelatin, gum tragacanth, methyl cellulose,hydroxypropylmethyl-cellulose, sodium carboxymethylcellulose, and/orpolyvinylpyrrolidone (PVP). If desired, disintegrating agents can beadded, such as the cross-linked polyvinyl pyrrolidone, agar, or alginicacid or a salt thereof such as sodium alginate.

Dragee cores are provided with suitable coatings. For this purpose,concentrated sugar solutions can be used, which can optionally containgum arabic, talc, polyvinyl pyrrolidone, carbopol gel, polyethyleneglycol, and/or titanium dioxide, lacquer solutions, and suitable organicsolvents or solvent mixtures. Dyestuffs or pigments can be added to thetablets or dragee coatings for identification or to characterizedifferent combinations of active compound doses.

Pharmaceutical preparations which can be used orally include push-fitcapsules made of gelatin, as well as soft, sealed capsules made ofgelatin and a plasticizer, such as glycerol or sorbitol. The push-fitcapsules can contain the active ingredients in admixture with fillersuch as lactose, binders such as starches, and/or lubricants such astalc or magnesium stearate and, optionally, stabilizers. In softcapsules, the active compounds can be dissolved or suspended in suitableliquids, such as fatty oils, liquid paraffin, or liquid polyethyleneglycols. In addition, stabilizers can be added. All formulations fororal administration should be in dosages suitable for suchadministration.

In some embodiments, a pharmaceutical composition for intravenousadministration may provide from about 0.1 to 100 mg per patient per day.Dosages from 0.1 up to about 100 mg per patient per day may be used.Substantially higher dosages are possible in topical administration.Actual methods for preparing parenterally administrable compositionswill be known or apparent to those skilled in the art and are describedin more detail in such publications as Remington: The Science andPractice of Pharmacy, 21st Edition 2005, Lippincott Williams & Wilkins,Publishers.

The pharmaceutical compositions can be administered in a variety ofdosage forms and amounts depending upon the method of administration.For example, unit dosage forms suitable for oral administration include,but are not limited to, powder, tablets, pills, capsules and lozenges.It is recognized that antibodies when administered orally, should beprotected from digestion. This is typically accomplished either bycomplexing the molecules with a composition to render them resistant toacidic and enzymatic hydrolysis, or by packaging the molecules in anappropriately resistant carrier, such as a liposome or a protectionbarrier. Means of protecting agents from digestion are well known in theart.

Pharmaceutical formulations, particularly, of the polypeptide andnucleic acid EMP2 inhibitors for according to the present invention canbe prepared by mixing an antibody having the desired degree of puritywith optional pharmaceutically acceptable carriers, excipients orstabilizers. Such formulations can be lyophilized formulations oraqueous solutions. Acceptable carriers, excipients, or stabilizers arenontoxic to recipients at the dosages and concentrations used.Acceptable carriers, excipients or stabilizers can be acetate,phosphate, citrate, and other organic acids; antioxidants (e.g.,ascorbic acid) preservatives low molecular weight polypeptides;proteins, such as serum albumin or gelatin, or hydrophilic polymers suchas polyvinylpyllolidone; and amino acids, monosaccharides,disaccharides, and other carbohydrates including glucose, mannose, ordextrins; chelating agents; and ionic and non-ionic surfactants (e.g.,polysorbate); salt-forming counter-ions such as sodium; metal complexes(e.g. Zn-protein complexes); and/or non-ionic surfactants. The antibodycan be formulated at a concentration of between 0.5-200 mg/ml, orbetween 10-50 mg/ml.

The compositions containing the EMP2 inhibitors of the invention (e.g.,anti-EMP2 antibodies and EMP2 polypeptides) can be administered fortherapeutic or prophylactic treatments. In therapeutic applications,compositions are administered to a patient in a “therapeuticallyeffective dose.” Single or multiple administrations of the compositionsmay be administered depending on the dosage and frequency as requiredand tolerated by the patient. A “patient” or “subject” for the purposesof the present invention includes both humans and other animals,particularly mammals. Thus the methods are applicable to both humantherapy and veterinary applications. In the preferred embodiment thepatient is a mammal, preferably a primate, and in the most preferredembodiment the patient is human.

The pharmaceutical compositions can comprise additional active agents,including any one or more of the following, analgesics,anti-inflammatories, antibiotics, antimicrobials, lubricants,contraceptives, spermicides, local anesthetics, and anti-puritics.

As used herein, the term “carrier” refers to a typically inert substanceused as a diluent or vehicle for an active agent to be applied to abiological system in vivo or in vitro. (e.g., drug such as a therapeuticagent). The term also encompasses a typically inert substance thatimparts cohesive qualities to the composition.

In some embodiments, the invention provides a composition comprising anEMP2 inhibitor and a physiologically acceptable carrier at the cellularor organismal level. Typically, a physiologically acceptable carrier ispresent in liquid, solid, or semi-solid form. Examples of liquidcarriers include physiological saline, phosphate buffer, normal bufferedsaline (135-150 mM NaCl), water, buffered water, 0.4% saline, 0.3%glycine, glycoproteins to provide enhanced stability (e.g., albumin,lipoprotein, globulin, etc.), and the like. Examples of solid orsemi-solid carriers include mannitol, sorbitol, xylitol, maltodextrin,lactose, dextrose, sucrose, glucose, inositol, powdered sugar, molasses,starch, cellulose, microcrystalline cellulose, polyvinylpyrrolidone,acacia gum, guar gum, tragacanth gum, alginate, extract of Irish moss,panwar gum, ghatti gum, mucilage of isapol husks, Veegum®, larcharabogalactan, gelatin, methylcellulose, ethylcellulose,carboxymethylcellulose, hydroxypropylmethylcellulose, polyacrylic acid(e.g., Carbopol), calcium silicate, calcium phosphate, dicalciumphosphate, calcium sulfate, kaolin, sodium chloride, polyethyleneglycol, and combinations thereof. Since physiologically acceptablecarriers are determined in part by the particular composition beingadministered as well as by the particular method used to administer thecomposition, there are a wide variety of suitable formulations ofpharmaceutical compositions of the present invention (see, e.g.,Remington's Pharmaceutical Sciences, 17^(th) ed., 1989). The carriersand compositions are preferably sterile.

The compositions of the present invention may be sterilized byconventional, well-known sterilization techniques or may be producedunder sterile conditions. Aqueous solutions can be packaged for use orfiltered under aseptic conditions and lyophilized, the lyophilizedpreparation being combined with a sterile aqueous solution prior toadministration. The compositions can contain pharmaceutically orphysiologically acceptable auxiliary substances as required toapproximate physiological conditions, such as pH adjusting and bufferingagents, tonicity adjusting agents, wetting agents, and the like, e.g.,sodium acetate, sodium lactate, sodium chloride, potassium chloride,calcium chloride, sorbitan monolaurate, and triethanolamine oleate.

Formulations suitable for oral administration can comprise: (a) liquidsolutions, such as an effective amount of a packaged platinum-based drugsuspended in diluents, e.g., water, saline, or PEG 400; (b) capsules,sachets, or tablets, each containing a predetermined amount of aplatinum-based drug, as liquids, solids, granules or gelatin; (c)suspensions in an appropriate liquid; and (d) suitable emulsions. Tabletforms can include one or more of lactose, sucrose, mannitol, sorbitol,calcium phosphates, corn starch, potato starch, microcrystallinecellulose, gelatin, colloidal silicon dioxide, talc, magnesium stearate,stearic acid, and other excipients, colorants, fillers, binders,diluents, buffering agents, moistening agents, preservatives, flavoringagents, dyes, disintegrating agents, and pharmaceutically compatiblecarriers. Lozenge forms can comprise an EMP2 Chlamydia inhibitor in aflavor, e.g., sucrose, as well as pastilles comprising a polypeptide orpeptide fragment in an inert base, such as gelatin and glycerin orsucrose and acacia emulsions, gels, and the like, containing, inaddition to the inhibitor, carriers known in the art.

Topical Compositions

In either the first or second aspect, the present invention providestopical pharmaceutical compositions comprising an EMP2 inhibitoraccording to the invention. More preferably, the inhibitor is a smallorganic compound, an EMP2 polypeptide, or anti-EMP2 antibody. Theinhibitor may be in a unit dosage form comprising per unit dosage anamount of a EMP2 inhibitor as provided above which is effective fortreating cancer or inhibiting infection by Chlamydia.

Also provided, in the first aspect, are methods of treating Chlamydiainfections by topically administering an effective amount of suchcompositions (e.g., in unit dosage form) to, or proximal to, theaffected area.

In either aspect, topical formulations of EMP2 inhibitors may beformulated in combination with a pharmaceutically acceptable carrier.Dosage forms for the topical administration of the compounds of thisinvention include powders, sprays, foams, jellies, ointments, pastes,creams, lotions, gels, solutions, patches, suppositories and liposomalpreparations. The dosage forms may be formulated with mucoadhesivepolymers for sustained release of active ingredients at the urogenitalarea. The active compound may be mixed under sterile conditions with apharmaceutically acceptable carrier, and with any preservatives,buffers, or propellants, which may be required. Topical preparations canbe prepared by combining the inhibitor t with conventionalpharmaceutical diluents and carriers commonly used in topical dry,liquid, cream and aerosol formulations. Ointment and creams may, forexample, be formulated with an aqueous or oily base with the addition ofsuitable thickening and/or gelling agents. Such bases may include waterand/or an oil such as liquid paraffin or a vegetable oil such as peanutoil or castor oil. Thickening agents which may be used according to thenature of the base include soft paraffin, aluminum stearate, cetostearylalcohol, propylene glycol, polyethylene glycols, woolfat, hydrogenatedlanolin, beeswax, and the like. Lotions may be formulated with anaqueous or oily base and, in general, also include one or more of thefollowing: stabilizing agents, emulsifying agents, dispersing agents,suspending agents, thickening agents, coloring agents, perfumes, and thelike. Powders may be formed with the aid of any suitable powder base,e.g., talc, lactose, starch, and the like. Drops may be formulated withan aqueous base or nonaqueous base also comprising one or moredispersing agents, suspending agents, solubilizing agents, and the like.

The ointments, pastes, creams and gels also may contain excipients, suchas animal and vegetable fats, oils, waxes, paraffins, starch,tragacanth, cellulose derivatives, polyethylene glycols, silicones,bentonites, silicic acid, talc and zinc oxide, or mixtures thereof.Powders and sprays also can contain excipients such as lactose, talc,silicic acid, aluminum hydroxide, calcium silicates and polyamidepowder, or mixtures of these substances. Sprays can additionally containcustomary propellants, such as chlorofluorohydrocarbons and volatileunsubstituted hydrocarbons, such as butane and propane.

In either aspect, the EMP2 inhibitor can be formulated with apharmaceutically acceptable carrier and at least one of the followingsecond pharmacologic agents: a local anesthetic (e.g., lidocaine,prilocalne, etc.), local anti-inflammatory agent (e.g., naproxen,pramoxicam, etc.), corticosteroid (e.g., cortisone, hydrocortisone,etc.), anti-itch agent (e.g., loperamide, diphylenoxalate, etc.), anagent that interferes with the activation of peripheral sensory neurons,including divalent and trivalent metal ions (e.g., manganese, calcium,strontium, nickel, lanthanum, cerium, zinc, etc.), analgesic agents, alubricant, yeast-based product (e.g., lyophilized yeast, yeast extract,etc.), a spermicide, growth-promoting and/or wound healing-promotingagent known to promote re-epithelialization (e.g., platelet-derivedgrowth factor (PDGF), interleukin-11 (IL-11), etc.), anti-microbialagent (e.g., Neosporin, polymyxin B sulfate, bacitracin zinc, etc.),mucoadhesive agent (e.g., cellulose derivatives, etc.), cytoprotectantagent (e.g., colloidal bismuth, misoprostol, sucralfate, etc.) asdefined in Goodman and Gilman, The Pharmacological Basis ofTherapeutics, or menthol.

In the first aspect, the EMP2 Chlamydia inhibitor may be present in thecomposition in unit dosage form effective for the treatment of theChlamydia infection. The at least one second pharmacological compound istypically present in the composition in unit dosage effective for thetreatment of a condition(s), symptom(s) or effect(s) associated with orresulting from the Chlamydia infection or activity related to itstransmission. The topical pharmaceutical compositions also can containother active ingredients such as antimicrobial agents, particularlyantibiotics, anesthetics, analgesics, contraceptive agents, lubricants,spermicides, and antipruritic agents. The topical pharmaceuticalcompositions can also include one or more preservatives orbacteriostatic agents, e.g., methyl hydroxybenzoate, propylhydroxybenzoate, chlorocresol, benzalkonium chlorides, and the like. Thetopical composition may be applied with an applicator, may be coated oneither or both surfaces of a condom or diaphragm or other contraceptivedevice. Particularly preferred antibiotics are those conventionally usedto treat a Chlamydia infection.

In either aspect of the invention, the dosage of a EMP2 inhibitordepends upon many factors that are well known to those skilled in theart, for example, the particular compound; the condition being treated;the age, weight, and clinical condition of the recipient patient; andthe experience and judgment of the clinician or practitioneradministering the therapy. An effective amount of the compound is thatwhich provides either subjective relief of symptoms or an objectivelyidentifiable improvement as noted by the clinician or other qualifiedobserver. The dosing range varies with the compound used, the route ofadministration and the potency of the particular compound.

In either aspect, the invention provides topical sustained and prolongedrelease pharmaceutical compositions comprising one or morepharmacological compounds described supra, and a pharmaceuticallyacceptable carrier, to treat a Chlamydia infection. Preferably, thecompositions are administered in unit dosage form to a subject in needof such treatment. Topical sustained and prolonged release compositionsare typically variants which include 1) an absorbent in a hydrophilicbase; 2) an absorbent in a hydrophobic base; and 3) coated beadscontaining an absorbent matrix dispersed in a suitable vehicle.

Such hydrophilic compositions and preparations of the invention comprisea compound of the invention and a polymer, such as cellulose (methylcellulose, ethyl cellulose, hydroxy propyl cellulose, etc.), highermolecular weight polyethylene glycol, methacrylic-acrylic acid emulsion,hydrogel, carbopol, ethyl vinyl acetate copolymer, or polyester, etc.,to bind the compound of interest to the polymer. The compound-polymermatrix is then dispersed in a hydrophilic vehicle to form a semi-solid.After administration of such hydrophilic composition into theappropriate urogenital area, such as, e.g., the vagina or urethraltract, the water in the semi-solid preparation is adsorbed and thepolymer matrix with the active ingredient (i.e., the pharmaceuticalcompound) remains as a coating in the area to which it has been applied.The pharmaceutical compound is then slowly released from this coating.

Hydrophobic compositions and preparations of the invention employsimilar polymers as used in the hydrophilic preparations, but thepolymer/compound matrix is dispersed into a vehicle, such a plastibase,in the hydrophobic compositions and preparations. Plastibase is amineral oil base that only partially dissolves the pharmaceuticalcompound. The semi-solid composition forms a thin coating on theurogenital region to which the composition has been applied (such as,e.g., the vagina or urethral tract) and slowly releases the activecompound. The prolonged action is controlled principally by thesolubility of the active ingredient in the vehicle.

The present invention also provides coated beads which are produced byfirst absorbing a compound of the present invention, or a combination ofcompounds, on a cellulosic material blended with polyethylene glycol,filler, binder and other excipients. The resulting matrix is thenextruded and spheronized (e.g., the process of making into spheres) tocreate small beads. The beads are then coated to an appropriatethickness with one or more of a suitable material, such as amethacrylic-acrylic polymer, polyurethane, ethyl vinyl acetatecopolymer, polyester, silastic, etc. The coating on the beads acts as arate controlling membrane that regulates the release of the compoundfrom the core beads.

Methods of Treatment

In both aspects, the terms “treating” or “treatment” includes:

(1) preventing the disease, i.e., causing the clinical symptoms of thedisease not to develop in a mammal that may be exposed to the organismbut does not yet experience or display symptoms of the disease,

(2) inhibiting the disease, i.e., arresting or reducing the developmentof the disease or its clinical symptoms. In its first aspect, thisincludes eliminating the infection or reducing the numbers of Chlamydiain the subject or infected tissue.

(3) relieving the disease, i.e., causing regression of the disease orits clinical symptoms.

In either aspect, the EMP2 inhibitors and pharmaceutical compositionsaccording to the invention may be administered by any route ofadministration (e.g., intravenous, topical, intraperitoneal, parenteral,oral, intravaginal, rectal, occularly). They may be administered as abolus or by continuous infusion over a period of time, by intramuscular,intraperitoneal, intracerobrospinal, subcutaneous, intra-articular,intrasynovial, intrathecal, oral, topical, or inhalation routes.Intravenous or subcutaneous administration of the antibody is preferred.The administration may be local or systemic. They may be administered toa subject who has been diagnosed with the subject disease (e.g., canceror a Chlamydia infection), a history of the disease, or is at risk ofthe disease (e.g., engages in activities wherein the disease is exposureto Chlamydia may occur). They may be administered to a subject whosedisease has been difficult to control or recurs after conventional ormain-stay therapy.

In the first aspect, they may be administered in conjunction withconventional antibiotic therapy for Chlamydia or with contraceptiveagents. In some embodiments, the methods include the step of firstdiagnosing the subject as having a Chlamydia infection and thenadministering the EMP2 Chlamydia inhibitor according to the invention.In some further embodiments, the diagnosis is achieved as describedbelow.

In some embodiments, the EMP2 Chlamydia inhibitors are used to treatchronic pelvic pain syndromes in a subject with Chlamydia infection. Theinhibitors in some other embodiments are used to treat ocular infectionswith Chlamydia or trachoma, the primary cause of infectious blindnessworldwide. In yet other embodiments, the inhibitors are used to treatinflammatory diseases (e.g., arthritis, arteriosclerosis) in a subjecthaving a Chlamydia infection.

In the second aspect, the siRNA and ribozyme EMP2 inhibitor formulationsof the invention may be administered to a cell. The cell can be providedas part of a tissue, such as an epithelial membrane, or as an isolatedcell, such as in tissue culture. The cell can be provided in vivo, exvivo, or in vitro. The formulations can be introduced into the tissue ofinterest in vivo or ex vivo by a variety of methods. In some embodimentsof the invention, the nucleic acids of the invention are introduced intocells by such methods as microinjection, calcium phosphateprecipitation, liposome fusion, or biolistics. In further embodiments,the nucleic acids are taken up directly by the tissue of interest.

Diagnosis of Chlamydia Infection

Diagnosis is based upon symptoms and detection of the bacteria in bodyfluids or samples as is known to one of ordinary skill in the art. Thetraditional method of diagnosis is inoculation of monolayer cell culturewith clinical specimens, followed by staining and visual examinationafter 2-3 days. Another more routine method requires the measurement ofantichlamydial antibody titer changes in the paired sera (four foldgreater rise in titer) and has a low predictive value for ongoinginfection. Direct tests such as ELISA and IF (immunofluorescence) areeasier to perform and require less time and labor than culturing of theorganism. These methods directly measure Chlamydia antigens. Theantigens used for the serological identification and differentiation ofChlamydiae are cell envelope antigens which are species specific. Thisantigens can distinguish C. trachomatis, C. psittaci and C. pneumoniaeand among the 15 serovars of C. trachomatis (serovar specific antigens).(see, for instance, Black, C. M., Clin Microbiol Rev 10: 160-184(1997)). In addition, DNA amplification methods are commerciallyavailable for the detection of Chlamydia specific RNA and DNA in bodyfluids.

Assays in the Diagnosis or Prognosis of Cancers which Express orOver-Express EMP2

The methods described herein involves measuring levels of EMP2expression. Levels of EMP2 can be determined in a number of ways whencarrying out the various methods of the invention. Various measurementsof the level of EMP2 can be used for example, in terms of number ofEMP2-positive cells per 100 cells in the tissue sample. Anothermeasurement of the level of EMP2 is a measurement of the change in thelevel of EMP2 over time. These measurements may be expressed in anabsolute amount or may be expressed in terms of a percentage increase ordecrease over time, in one particularly important measurement, the levelof EMP2 is measured in relation to levels in a control cell or glandsample.

Levels of EMP2 are advantageously compared to controls according to theinvention. The control maybe a predetermined value, which can take avariety of forms. It can be a single cut-off value, such as a median ormean. It can be established based upon comparative groups, such as ingroups not having elevated unopposed estrogen levels and groups havingelevated unopposed estrogen levels. Another example of comparativegroups would be groups having a particular disease, condition orsymptoms and groups without the disease, condition or symptoms such as agroup with premalignancy or cancer and a group without premalignancy orcancer. Another comparative group would be a group with a family historyof a condition such as cancer and a group without such a family history.The predetermined value can be arranged, for example, where a testedpopulation is divided equally (or unequally) into groups, such as alow-risk group, a medium-risk group and a high-risk group or intoquadrants or quintiles, the lowest quadrant or quintile beingindividuals with the lowest risk or highest amount of EMP2 and thehighest quadrant or quintile being individuals with the highest risk orlowest amount of EMP2.

Still other controls can be based on other cells or glands within asingle tissue sample. For example, endometrial glands that express EMP2may be located adjacent to endometrial glands that express reducedlevels of EMP2. These glands that express EMP2 can serve as positivecontrols for comparison with glands having reduced EMP2 antibodystaining. Likewise, stromal and other cells in an endometrial tissuesample will express EMP2 and can be used as controls.

The predetermined value of a control will depend upon the particularpopulation selected. For example, an apparently healthy population willhave a different “normal” range than will a population which is known,for instance, to have a condition related to endometrial premalignancy,endometrial cancer, or elevated unopposed estrogen levels. Accordingly,the predetermined value selected may take into account the category inwhich an individual falls. Appropriate ranges and categories can beselected with no more than routine experimentation by those of ordinaryskill in the art. By “elevated” it is meant high relative to a selectedcontrol. Typically the control will be based on apparently healthynormal individuals in an appropriate age bracket.

It will also be understood that the controls according to the inventionmay be, in addition to predetermined values, samples of materials testedin parallel with the experimental materials. Examples include samplesfrom control populations or control samples generated throughmanufacture to be tested in parallel with the experimental samples. Asused herein a “matched” control means tissue or cells obtained at thesame time from the same subject, for example, parts of a single biopsy,or parts of a single cell sample from the subject.

In a related aspect, the clinical populations can be analyzed by variousstatistical methods, including, but not limited to, multivariateanalysis (see, e.g., Turner et al., J Clin Oncol 19(4):992-1000 (2001)).Further, such analysis may include survival analysis and othertechniques for elucidating clinical data (see, e.g., Klein andMoeschberger, Survival Analysis: Techniques for Censored and TruncatedData, 2003, Springer-Verlag Publishing Co., New York, N.Y.).

The various assays used to determine the levels of EMP2 include:specific binding assays, using materials which bind specifically toEMP2; gel electrophoresis; and the like. Immunoassays may be usedaccording to the invention including sandwich-type assays, competitivebinding assays, one-step direct tests and two-step tests such asdescribed herein. Preferably EMP2 levels are determined bynondestructive imaging of EMP2 expression, in preferred embodiments, theimaging is real-time imaging and/or permits visualization of EMP2distribution.

As disclosed herein, it is also possible to assess likelihood ofpremalignancy by monitoring changes in the absolute or relative amountsof EMP2 over time. For example, an increase in EMP2 expression inindividual endometrial glands correlates with increasing likelihood ofendometrial premalignancy arising in such glands. Accordingly one canmonitor EMP2 expression over time to determine if the likelihood ofendometrial premalignancy in a subject is changing. Increases inrelative or absolute EMP2 may indicate an abnormality, for example anonset or progression of endometrial premalignancy or endometrial cancer.Decreases in amounts of EMP2 expressed in endometrial glands over timemay indicate a decrease in premalignancy or endometrial cancer remissionor regression.

The invention in another aspect provides a diagnostic method todetermine the effectiveness of treatments. The “evaluation of treatment”as used herein, means the comparison of a subject's levels of EMP2measured in samples collected from the subject at different sampletimes, preferably at least 1 month apart following treatment. Thepreferred time to obtain the second sample from the subject is at leastone month after obtaining the first sample, which means the secondsample is obtained at any time following the day of the first samplecollection, preferably at least 30, 45, 60 or more days after the timeof first sample collection.

The comparison of levels of EMP2 in two or more samples, taken ondifferent days, allows evaluation of disease progression or regressionand of the effectiveness of anticancer treatment. The comparison of asubject's levels of EMP2 measured in samples obtained on different daysprovides a measure to determine the effectiveness of any treatment toavoid or eliminate a premalignancy.

As will be appreciated by those of ordinary skill in the art, theevaluation of the treatment also may be based upon an evaluation of thesymptoms or clinical end-points of the associated disease. Thus, themethods of the invention also provide for determining the regression,progression, or onset of a condition which is characterized by increasedlevels of EMP2. In some instances, the subjects to which the methods ofthe invention are applied are already diagnosed as having a particularcondition or disease. In other instances, the measurement will representthe diagnosis of the condition or disease, in some instances, thesubjects will already be undergoing therapy for premalignancy or cancer,while in other instances the subjects will be without present therapyfor premalignancy or cancer.

Accordingly, the present invention relates to alterations in EMP2expression and disorders of EMP2 regulation which play a role in thepathogenesis of cancer (e.g, endometrial premalignancies, and ultimatelyin the development of endometrial cancer (EC)). By correlatingalterations in the expression of EMP2 with disease status, EMP2 isdisclosed as a useful biological marker for diagnosis, staging, imaging,and as a therapeutic target for the treatment of cancers which expressor overexpress EMP2 (e.g., the premalignant endometrial phenotype andEC).

In one embodiment, a method is disclosed for determining the likelihoodof a group of cells becoming cancerous, including determining the levelof EMP2 polypeptide in a test sample, where increased levels of EMP2polypeptide in the test sample relative to a control sample correlateswith the cells having an increased likelihood of becoming cancerous.Thus, the invention provides a method for determining whether a subjecthas or is at risk of having cancer wherein the cancer is of a kindassociated with the over-expression of EMP2.

In a related aspect, immunohistochemistry is performed, where the levelof EMP2 expression is determined by antibody binding. In one aspect, theantibody binds to an amino acid sequence of EMP2. In a further relatedaspect, determining the frequency of detecting EMP2 in a sample andcomparing the frequency of detection with multiple variables to generatemultivariate models for the identification of variables demonstratingstatistical significance for patient survival is disclosed, where suchvariables include ER, PR, vascular, stage, diagnosis, disease status,and survival status.

In another embodiment, a method for monitoring the progression ofpremalignancy in a subject is disclosed including determining the levelof EMP2 polypeptide in cells obtained at a first time, determining thelevel of EMP2 polypeptide in cells obtained at a second time, andcomparing the levels of EMP2 polypeptide the cells at the first andsecond times, where increased levels of EMP2 polypeptide at the secondtime relative to the first time correlates with progression ofpremalignancy to a cancerous stage.

In one embodiment, a method of monitoring the stage of cancer in asubject is disclosed, including identifying a subject presenting cancer,determining EMP2 polypeptide level in a sample of tissue from thesubject to establish a baseline EMP2 level for the subject, measuringEMP2 polypeptide level in an endometrial tissue sample obtained from thesame subject at subsequent time points, and comparing the measured EMP2polypeptide level with the baseline EMP2 polypeptide level, where anincrease in measured EMP2 polypeptide levels in the subject versusbaseline EMP2 polypeptide levels is associated with a cancer which isprogressing, and where a decrease in measured EMP2 polypeptide levelsversus baseline EMP2 polypeptide level is associated with a cancer whichis regressing or in remission.

In another embodiment, a method for screening a candidate compound thataffects the premalignant phenotype is disclosed, including culturingtissue or cells, determining the level of EMP2 polypeptide in thecultured tissue or cells at a first time point, contacting the culturedtissue or cells with a candidate compound, determining the level of EMP2polypeptide in the cultured tissue or cells subsequent to compoundcontact, and comparing the levels of EMP2 before and after compoundcontact, where a change in the amount of binding after compound contactcorrelates with a compound induced alteration in the level of EMP2.

In a related aspect, an increase in the level of EMP2 correlates withthe onset of or progression of an premalignant cell phenotype. In afurther related aspect, a decrease in the level of EMP2 correlates withthe regression of an premalignant phenotype.

In one aspect, the candidate compound is a modulator of a progesteronereceptor DNA binding domain, NF-κB, a serum response element, or PPAR.

In some embodiments, the cancer is one which overexpresses EMP2 relativeto the non-cancerous state. EMP2 is overexpressed in a number of classesof tumor, including endometrial cancer, ovarian cancer, glioblastoma,breast cancer, prostate cancer, testicular cancer, and myeloma. In somepreferred embodiments of any of the above, the antibody used is adiabody (e.g., KS49, KS83, KS41, KS89) as disclosed herein. PCT PatentPublication No. WO 2006/094014 which describes the use of antibodies indetection of EMP2 in the context of endometrial cancer is incorporatedherein by reference with respect to the technologies used to detecttarget molecules in vivo, and particularly, with respect to endometrialcancer. In some embodiments of the second aspect, the subject cancerwhich expresses or overexpresses EMP2 is not endometrial cancer and/orthe subject tissue is not endometrium.

In some embodiments, the invention provides a method for determining thelikelihood of an endometrial cell becoming cancerous, comprising:determining the level of endothelial membrane protein 2 polypeptide in atest sample, wherein increased levels of EMP2 polypeptide in the testsample relative to a control sample correlates with the cells having anincreased likelihood of becoming cancerous. In some further embodiments,the immunohistochemistry on a group of cells uses an anti-endothelialmembrane protein 2 EMP2 antibody or antigen binding fragment thereof;and determines the binding of the antibody or antigen binding fragmentthereof to the cells, wherein an increased amount of antibody orantigen-binding fragment thereof bound to the cells relative to acontrol group correlates with the cells having an increased likelihoodof becoming cancerous

In additional embodiments, the invention provides methods of monitoringthe progression of premalignancy in a subject, comprising: determiningthe level of epithelial membrane protein 2 (EMP2) polypeptide in cellfrom a tissue sample obtained at a first time; determining the level ofEMP2 polypeptide in a cell from an tissue sample obtained at a secondtime; and comparing the levels of EMP2 polypeptide n the cell at thefirst and second times, wherein increased levels of EMP2 polypeptide atthe second time relative to the first time correlates with progressionof premalignancy to a cancerous stage. In some embodiments, the subjectis undergoing drug therapy at the premalignant stage or malignant stage.

In yet other embodiments, the invention provides a method of monitoringthe stage of cancer in a subject by identifying a subject presenting thecancer; determining EMP2 polypeptide level in a sample of tissue fromthe cancer to establish a baseline EMP2 level for the subject; measuringEMP2 polypeptide level in a tissue sample obtained from the same subjectat subsequent time points; and comparing the measured EMP2 polypeptideor level with the baseline EMP2 polypeptide level, wherein an increasein measured EMP2 polypeptide in the subject versus baseline EMP2polypeptide level is associated with a cancer which is progressing, andwherein a decrease in measured EMP2 polypeptide level versus baselineEMP2 polypeptide or polynucleotide level is associated with a cancerwhich is regressing or in remission.

In some embodiments, the invention provides a kit comprising: an agentwhich detects the level of epithelial membrane protein 2 (EMP2); acontainer comprising the agent for detecting the level of EMP2 in asample; a control; and instructions to provide guidance for carrying outan assay embodied by the kit and for making a determination of the levelof EMP2 based upon that assay. In preferred embodiments, the agent is adiabody. In further embodiments of the above, the kit also contains EMP2protein as a positive control. In some preferred embodiments of any ofthe above, the antibody used is a diabody (e.g., KS49, KS83, KS41, KS89)as disclosed herein.

In some embodiments, treatment of a cancer which expresses oroverexpresses EMP21 generally involve the repeated administration of theEMP2 antibodies, immunoconjugates, inhibitors, and siRNA preparationsvia an acceptable route of administration such as intravenous injection(IV), at an effective dose. Dosages will depend upon various factorsgenerally appreciated by those of skill in the art, including withoutlimitation the type of cancer and the severity, grade, or stage of thecancer, the binding affinity and half life of the agents used, thedegree of EMP2 expression in the target tissues of the patient, theextent of circulating shed EMP2 antigen, the desired steady-stateantibody concentration level, frequency of treatment, and the influenceof chemotherapeutic agents used in combination with the treatment methodof the invention. Daily doses may range from about 0.1 to 100 mg/kg.Doses in the range of 10-500 mg of the mAb or immunoconjugates per weekmay be effective and well tolerated, although even higher weekly dosesmay be appropriate and/or well tolerated. The principal determiningfactor in defining the appropriate dose is the amount of a particularagent necessary to be therapeutically effective in a particular context.Repeated administrations may be required in order to achieve tumorinhibition or regression. Initial loading doses may be higher. Theinitial loading dose may be administered as an infusion. Periodicmaintenance doses may be administered similarly, provided the initialdose is well tolerated.

The invention further provides vaccines formulated to contain EMP2protein or fragment thereof, particularly, a fragment as recognized by adiabody disclosed herein. The use of a tumor antigen in a vaccine forgenerating humoral and cell-mediated immunity for use in anti-cancertherapy is well known in the art and, for example, has been employed inprostate cancer using human PSMA and rodent PAP immunogens (Hodge etal., 1995, Int. J. Cancer 63: 231-237; Fong et al., 1997, J. Immunol.159: 3113-3117).

The invention further provides methods for inhibiting the biologicalactivity of EMP2. The methods comprises contacting an amount of the EMP2with an antibody or immunoconjugate of the invention under conditionsthat permit an EMP2-antibody complex to form thereby, respectively,blocking EMP2 activity.

In some embodiments, the invention provides a method of treating cancer,particularly a cancer which overexpresses EMP2 or of inhibiting thegrowth of a cancer cell overexpressing a EMP2 protein by treating asubject or contacting the cancer cell with an antibody or fragmentthereof that recognizes and binds the EMP2 protein in an amounteffective to inhibit the growth of the cancer cell. In some embodiments,the cancer cell is an endometrial cancer cell. The contacting antibodycan be a monoclonal antibody and/or a chimeric antibody. In someembodiments, the chimeric antibody comprises a human immunoglobulinconstant region. In some embodiments, the antibody is a human antibodyor comprises a human immunoglobulin constant region. In furtherembodiments, the antibody fragment comprises an Fab, F(ab)₂, or Fv. Inother embodiments, the fragment comprises a recombinant protein havingan antigen-binding region.

In another embodiment, the invention provides methods for treatingcancer, particularly, a cancer overexpressing EMP2 or selectivelyinhibiting a cell expressing or overexpressing a EMP2 by contacting anyone or a combination of the immunoconjugates of the invention with thecell in an amount sufficient to inhibit the cell. Such amounts includean amount to kill the cell or an amount sufficient to inhibit cellgrowth or proliferation. As discussed supra the dose and dosage regimenwill depend on the nature of the disease or disorder to be treated, itspopulation, the site to which the antibodies are to be directed, thecharacteristics of the particular immunotoxin, and the patient. Forexample, the amount of immunoconjugate can be in the range of 0.1 to 200mg/kg of patient weight. The immunoconjugate can comprise the anti-EMP2antibody or the fragment linked to a therapeutic agent. The therapeuticagent can be cytotoxic agent. The cytotoxic agent can be selected from agroup consisting of ricin, ricin A-chain, doxorubicin, daunorubicin,taxol, ethiduim bromide, mitomycin, etoposide, tenoposide, vincristine,vinblastine, colchicine, dihydroxy anthracin dione, actinomycin D,diphteria toxin, Pseudomonas exotoxin (PE) A, PE40, abrin, arbrin Achain, modeccin A chain, alpha-sarcin, gelonin mitogellin,retstrictocin, phenomycin, enomycin, curicin, crotin, calicheamicin,sapaonaria officinalis inhibitor, maytansinoids, andglucocorticoidricin. The therapeutic agent can be a radioactive isotope.The therapeutic isotope can be selected from the group consisting of²¹²Bi, ¹³¹I, ¹¹¹In, ⁹⁰Y and ¹⁸⁶Re.

In any of the embodiments above, a chemotherapeutic drug and/orradiation therapy can be administered further. In some embodiments, thepatient also receives hormone antagonist therapy. The contacting of thepatient with the antibody or antibody fragment, can be by administeringthe antibody to the patient intravenously, intraperitoneally,intramuscularly, intratumorally, or intradermally.

In some embodiments, the immunoconjugate has a cytotoxic agent which isa small molecule. Toxins such as maytansin, maytansinoids, saporin,gelonin, ricin or calicheamicin and analogs or derivatives thereof arealso suitable. Other cytotoxic agents that can be conjugated to theanti-EMP2 antibodies include BCNU, streptozoicin, vincristine and5-fluorouracil. Enzymatically active toxins and fragments thereof canalso be used. The radio-effector moieties may be incorporated in theconjugate in known ways (e.g., bifunctional linkers, fusion proteins).The antibodies of the present invention may also be conjugated to aneffector moiety which is an enzyme which converts a prodrug to an activechemotherapeutic agent. See, WO 88/07378; U.S. Pat. No. 4,975,278; andU.S. Pat. No. 6,949,245. The antibody or immunoconjugate may optionallybe linked to nonprotein polymers (e.g., polyethylene glycol,polypropylene glycol, polyoxyalkylenes, or copolymers of polyethyleneglycol and polypropylene glycol).

Conjugates of the antibody and cytotoxic agent may be made using methodswell known in the art (see, U.S. Pat. No. 6,949,245). For instance, theconjugates may be made using a variety of bifunctional protein couplingagents such as N-succinimidyl-3-(2-pyridyldithiol) propionate (SPDP),succinimidyl-4-(N-maleimidomethyl)cyclohexane-1-carboxylate,iminothiolane (IT), bifunctional derivatives of imidoesters (such asdimethyl adipimidate HCL), active esters (such as disuccinimidylsuberate), aldehydes (such as glutareldehyde), bis-azido compounds (suchas bis(p-azidobenzoyl)hexanediamine), bis-diazonium derivatives (such asbis-(p-diazoniumbenzoyl)-ethylenediamine), diisocyanates (such astolyene 2,6-diisocyanate), and bis-active fluorine compounds (such as1,5-difluoro-2,4-dinitrobenzene). For example, a ricin immunotoxin canbe prepared as described in Vitetta et al. Science 238: 1098 (1987).Carbon-14-labeled 1-isothiocyanatobenzyl-3-methyldiethylenetriaminepentaacetic acid (MX-DTPA) is an exemplary chelating agent forconjugation of radionucleotide to the antibody. See WO94/11026. Thelinker may be a “cleavable linker” facilitating release of the cytotoxicdrug in the cell. For example, an acid-labile linker,peptidase-sensitive linker, dimethyl linker or disulfide-containinglinker (Chari et al. Cancer Research 52: 127-131 (1992)) may be used.

Methods of Administration and Formulation

The anti-EMP2 antibodies or immunoconjugates are administered to a humanpatient in accord with known methods, such as intravenousadministration, e.g., as a bolus or by continuous infusion over a periodof time, by intramuscular, intraperitoneal, intracerobrospinal,subcutaneous, intra-articular, intrasynovial, intrathecal, oral,topical, or inhalation routes. Intravenous or subcutaneousadministration of the antibody is preferred. The administration may belocal or systemic.

The compositions for administration will commonly comprise an agent asdescribed herein (dissolved in a pharmaceutically acceptable carrier,preferably an aqueous carrier. A variety of aqueous carriers can beused, e.g., buffered saline and the like. These solutions are sterileand generally free of undesirable matter. These compositions may besterilized by conventional, well known sterilization techniques. Thecompositions may contain pharmaceutically acceptable auxiliarysubstances as required to approximate physiological conditions such aspH adjusting and buffering agents, toxicity adjusting agents and thelike, for example, sodium acetate, sodium chloride, potassium chloride,calcium chloride, sodium lactate and the like. The concentration ofactive agent in these formulations can vary widely, and will be selectedprimarily based on fluid volumes, viscosities, body weight and the likein accordance with the particular mode of administration selected andthe patient's needs.

Thus, a typical pharmaceutical composition for intravenousadministration will vary according to the agent. Actual methods forpreparing parenterally administrable compositions will be known orapparent to those skilled in the art and are described in more detail insuch publications as Remington's Pharmaceutical Science, 15th ed., MackPublishing Company, Easton, Pa. (1980).

The pharmaceutical compositions can be administered in a variety of unitdosage forms depending upon the method of administration. For example,unit dosage forms suitable for oral administration include, but are notlimited to, powder, tablets, pills, capsules and lozenges. It isrecognized that antibodies when administered orally, should be protectedfrom digestion. This is typically accomplished either by complexing themolecules with a composition to render them resistant to acidic andenzymatic hydrolysis, or by packaging the molecules in an appropriatelyresistant carrier, such as a liposome or a protection barrier. Means ofprotecting agents from digestion are well known in the art.

Pharmaceutical formulations, particularly, of the antibodies andimmunoconjugates and inhibitors for use with the present invention canbe prepared by mixing an antibody having the desired degree of puritywith optional pharmaceutically acceptable carriers, excipients orstabilizers. Such formulations can be lyophilized formulations oraqueous solutions. Acceptable carriers, excipients, or stabilizers arenontoxic to recipients at the dosages and concentrations used.Acceptable carriers, excipients or stabilizers can be acetate,phosphate, citrate, and other organic acids; antioxidants (e.g.,ascorbic acid) preservatives low molecular weight polypeptides;proteins, such as serum albumin or gelatin, or hydrophilic polymers suchas polyvinylpyllolidone; and amino acids, monosaccharides,disaccharides, and other carbohydrates including glucose, mannose, ordextrins; chelating agents; and ionic and non-ionic surfactants (e.g.,polysorbate); salt-forming counter-ions such as sodium; metal complexes(e.g. Zn-protein complexes); and/or non-ionic surfactants. The antibodycan be formulated at a concentration of between 0.5-200 mg/ml, orbetween 10-50 mg/ml.

The formulation may also provide additional active compounds, including,chemotherapeutic agents, cytotoxic agents, cytokines, growth inhibitoryagent, and anti-hormonal agent. The active ingredients may also preparedas sustained-release preparations (e.g., semi-permeable matrices ofsolid hydrophobic polymers (e.g., polyesters, hydrogels (for example,poly(2-hydroxyethyl-methacrylate), or poly(vinylalcohol)), polylactides.The antibodies and immunocongugates may also be entrapped inmicrocapsules prepared, for example, by coacervation techniques or byinterfacial polymerization, for example, hydroxymethylcellulose orgelatin microcapsules and poly-(methylmethacylate) microcapsules,respectively, in colloidal drug delivery systems (for example,liposomes, albumin microspheres, microemulsions, nano-particles andnanocapsules) or in macroemulsions.

The compositions can be administered for therapeutic or prophylactictreatments. In therapeutic applications, compositions are administeredto a patient suffering from a disease (e.g., cancer) in a“therapeutically effective dose.” Amounts effective for this use willdepend upon the severity of the disease and the general state of thepatient's health. Single or multiple administrations of the compositionsmay be administered depending on the dosage and frequency as requiredand tolerated by the patient. A “patient” or “subject” for the purposesof the present invention includes both humans and other animals,particularly mammals. Thus the methods are applicable to both humantherapy and veterinary applications. In the preferred embodiment thepatient is a mammal, preferably a primate, and in the most preferredembodiment the patient is human. Other known cancer therapies can beused in combination with the methods of the invention. For example, thecompositions for use according to the invention may also be used totarget or sensitize a cell to other cancer therapeutic agents such asSFU, vinblastine, actinomycin D, cisplatin, methotrexate, and the like.

In other embodiments, the methods of the invention with other cancertherapies (e.g, radical prostatectomy), radiation therapy (external beamor brachytherapy), hormone therapy or chemotherapy. Radicalprostatectomy involves removal of the entire prostate gland plus somesurrounding tissue. This treatment is used commonly when the cancer isthought not to have spread beyond the tissue. Radiation therapy iscommonly used to treat prostate cancer that is still confined to theprostate gland, or has spread to nearby tissue. If the disease is moreadvanced, radiation may be used to reduce the size of the tumor. Hormonetherapy is often used for patients whose prostate cancer has spreadbeyond the prostate or has recurred. The objective of hormone therapy isto lower levels of the male hormones, androgens and thereby cause theprostate cancer to shrink or grow more slowly.

The combined administrations contemplates coadministration, usingseparate formulations or a single pharmaceutical formulation, andconsecutive administration in either order, wherein preferably there isa time period while both (or all) active agents simultaneously exerttheir biological activities.

Molecules and compounds identified that indirectly or directly modulatethe expression and/or function of a EMP2 can be useful in treatingcancers that, respectively, overexpress EMP2. These modulators can beadministered alone or co-administered in combination with conventionalchemotherapy, radiotherapy or immunotherapy as well as currentlydeveloped therapeutics.

Formulations suitable for oral administration can consist of (a) liquidsolutions, such as an effective amount of the packaged nucleic acidsuspended in diluents, such as water, saline or PEG 400; (b) capsules,sachets or tablets, each containing a predetermined amount of the activeingredient, as liquids, solids, granules or gelatin; (c) suspensions inan appropriate liquid; and (d) suitable emulsions. Tablet forms caninclude one or more of lactose, sucrose, mannitol, sorbitol, calciumphosphates, corn starch, potato starch, microcrystalline cellulose,gelatin, colloidal silicon dioxide, talc, magnesium stearate, stearicacid, and other excipients, colorants, fillers, binders, diluents,buffering agents, moistening agents, preservatives, flavoring agents,dyes, disintegrating agents, and pharmaceutically compatible carriers.Lozenge forms can comprise the active ingredient in a flavor, e.g.,sucrose, as well as pastilles comprising the active ingredient in aninert base, such as gelatin and glycerin or sucrose and acaciaemulsions, gels, and the like containing, in addition to the activeingredient, carriers known in the art.

The compound of choice, alone or in combination with other suitablecomponents, can be made into aerosol formulations (i.e., they can be“nebulized”) to be administered via inhalation. Aerosol formulations canbe placed into pressurized acceptable propellants, such asdichlorodifluoromethane, propane, nitrogen, and the like.

Suitable formulations for rectal administration include, for example,suppositories, which consist of the packaged nucleic acid with asuppository base. Suitable suppository bases include natural orsynthetic triglycerides or paraffin hydrocarbons. In addition, it isalso possible to use gelatin rectal capsules which consist of acombination of the compound of choice with a base, including, forexample, liquid triglycerides, polyethylene glycols, and paraffinhydrocarbons.

Formulations suitable for parenteral administration, such as, forexample, by intraarticular (in the joints), intravenous, intramuscular,intratumoral, intradermal, intraperitoneal, and subcutaneous routes,include aqueous and non-aqueous, isotonic sterile injection solutions,which can contain antioxidants, buffers, bacteriostats, and solutes thatrender the formulation isotonic with the blood of the intendedrecipient, and aqueous and non-aqueous sterile suspensions that caninclude suspending agents, solubilizers, thickening agents, stabilizers,and preservatives. In the practice of this invention, compositions canbe administered, for example, by intravenous infusion, orally,topically, intraperitoneally, intravesically or intrathecally.Parenteral administration, oral administration, and intravenousadministration are the preferred methods of administration. Theformulations of compounds can be presented in unit-dose or multi-dosesealed containers, such as ampules and vials.

Injection solutions and suspensions can be prepared from sterilepowders, granules, and tablets of the kind previously described. Cellstransduced by nucleic acids for ex vivo therapy can also be administeredintravenously or parenterally as described above.

The pharmaceutical preparation is preferably in unit dosage form. Insuch form the preparation is subdivided into unit doses containingappropriate quantities of the active component. The unit dosage form canbe a packaged preparation, the package containing discrete quantities ofpreparation, such as packeted tablets, capsules, and powders in vials orampoules. Also, the unit dosage form can be a capsule, tablet, cachet,or lozenge itself, or it can be the appropriate number of any of thesein packaged form. The composition can, if desired, also contain othercompatible therapeutic agents.

Preferred pharmaceutical preparations deliver one or more active EMP2modulators, optionally in combination with one or more chemotherapeuticagents or immunotherapeutic agents, in a sustained release formulation.Typically, the EMP2 modulator is administered therapeutically as asensitizing agent that increases the susceptibility of tumor cells toother cytotoxic cancer therapies, including chemotherapy, radiationtherapy, immunotherapy and hormonal therapy.

In therapeutic use for the treatment of cancer, the EMP2 modulators orinhibitors utilized in the pharmaceutical method of the invention areadministered at the initial dosage of about 0.001 mg/kg to about 1000mg/kg daily. A daily dose range of about 0.01 mg/kg to about 500 mg/kg,or about 0.1 mg/kg to about 200 mg/kg, or about 1 mg/kg to about 100mg/kg, or about 10 mg/kg to about 50 mg/kg, can be used. The dosages,however, may be varied depending upon the requirements of the patient,the severity of the condition being treated, and the compound beingemployed. For example, dosages can be empirically determined consideringthe type and stage of cancer diagnosed in a particular patient. The doseadministered to a patient, in the context of the present inventionshould be sufficient to effect a beneficial therapeutic response in thepatient over time. The size of the dose also will be determined by theexistence, nature, and extent of any adverse side-effects that accompanythe administration of a particular vector, or transduced cell type in aparticular patient. Determination of the proper dosage for a particularsituation is within the skill of the practitioner. Generally, treatmentis initiated with smaller dosages which are less than the optimum doseof the compound. Thereafter, the dosage is increased by small incrementsuntil the optimum effect under circumstances is reached. Forconvenience, the total daily dosage may be divided and administered inportions during the day, if desired.

EXAMPLES

The following examples are offered to illustrate, but not to limit theclaimed invention.

Example 1 Methods for Studying Chlamydial Infectivity and EMP2Chlamydial Inhibitors

A. Endometrial Cell Lines and Chlamydia Strains.

The human endometrial adenocarcinoma cell line HEC1A (HTB112, ATCC,Manassas, Va.) was cultured in McCoy 5a media (Invitrogen, Carlsbad,Calif.) supplemented with 10% fetal calf serum (Hyclone, Logan, Utah) at37° C. in a humidified 5% CO₂ and passaged every 7 days. EMP2-modulatedHEC1A sublines were stable transfectants with expression plasmids forGFP, a human EMP2-GFP fusion protein, or a human EMP2-specific ribozyme(HEC1A-GFP, HEC1A-hEMP2, and HEC1A-hRV2). EMP2 protein expression levelsrelative to HEC1A-GFP were 1.0, 8.7, and 0.2, respectively.

An 8-strain mix of human C. trachomatis (serovars D, E, F, and K) and C.muridarum were purified, aliquoted, and stored at −80° C. until readyfor use (see, Caldwell, H. D., et al., Infect Immun 31, 1161-76 (1981).All Chlamydia samples were made in Eagle MEM (Invitrogen) with 10% fetalcalf serum (Atlanta Biologicals, GA), 3 mg/ml glucose (FisherScientific, PA), 1.25 μg/ml Fungizone (Invitrogen), 100 μg/ml Vancomycin(Invitrogen), 100 μg/ml gentamicin (Invitrogen), and 0.5 μg/mlcycloheximide (Sigma, St. Louis, Mo.) and kept on ice until use.

B. Antibodies and Peptides.

Antibodies to human EMP2 were produced by immunization of rabbits withSEQ ID NO.: 2 EDIHDKNAKFYPVTREGSYG, a peptide in the secondextracellular loop of human EMP2 (see, Wang, C. X., et al., Blood 97,3890-5 (2001)). In peptide blocking experiments, this peptide was usedto assure specificity of binding whereas a control 20mer peptide fromthe first extracellular loop of human EMP2 was used as a negativecontrol. Antibody from the pre-immune rabbits was used as a negativecontrol. For immunohistochemical detection of Chlamydia EBs orinclusions, an anti-Chlamydia LPS mouse antibody (clone EV1-H1) was usedas kindly provided by Dr. Harlan Caldwall (Laboratory of IntracellularParasites, National Institutes of Health, Hamilton, Mont.). FITC- andTexas Red-conjugated goat anti-rabbit IgG was from Jackson Immunotech(West Grove, Pa.); FITC anti-mouse IgG, and horseradishperoxidase-conjugated anti-rabbit or anti-mouse IgG antibody were fromSouthern Biotechnology Associates, Birmingham, Ala.). Rabbit anti-humanβ-actin was from Sigma.

C. Chlamydia Infection.

HEC1A cells were plated at a concentration of 2.5×10⁵ cells/ml andincubated overnight to establish mono-layers. Infection with C.trachomatis or C. muridarum at multiplicity of infection (MOI) of0.5-3.0 was performed in media containing cycloheximide at 35° C. with5% CO₂ for 24 hours. Cells were fixed in methanol and inclusion bodieswere identified immunohistochemically using mouse anti-Chlamydia LPS andFITC anti-mouse IgG secondary antibody. Cells were counter stained withEvans Blue, mounted in glycerol, and scored using fluorescencemicroscopy. For the antibody study, cells were incubated with antibodyfor 1 hour at 37° C. before the infection step. For peptide blocking,antibody was mixed with peptide at indicated concentrations for 1 hourat room temperature prior to addition to cell cultures.

D. Chlamydia Attachment.

HEC1A cells were plated at 1×10⁴ cells/ml and incubated overnight. Cellswere infected with C. trachomatis at MOI of 50. Cells were thenincubated for 1.5 hrs at 4° C. Attached Chlamydia elementary bodies wereidentified using immunohistochemistry as described above, and countedwith fluorescent microscopy (magnification, 1000×). For the antibodystudies, cells were treated as described above.

E. Fluorescence Microscopy.

Chlamydia inclusions and elementary bodies were identified with anepiillumination fluorescent microscope (Olympus, Melville, N.Y.) usingFITC and Texas Red filters. Chlamydia inclusions were defined by round,regular shape, with a diameter of approximately ⅓ of cell size. In orderto prevent biased counting, the plates were scored in a masked fashionby at least two independent observers. 5-10 random fields were selectedfrom each well and the total number of cells with inclusions (C1) andwithout inclusions (C0) were counted. The rate of infection wascalculated (C1/(C1+C0)×100) from these numbers. For the attachmentstudy, the number of elementary bodies on the cell membrane of 100cells/slide was counted in a masked fashion. Areas with clustered cellsor indistinguishable inclusions were not counted. Experiments wereperformed with 2-3 replicate samples, and repeated at least three times.

F. Western Immunoblots.

Cellular lysates in Laemmli buffer were treated withpeptide-N-glycosidase F (PNGase; New England Biolabs, Beverly, Mass.) toremove N-linked glycans to convert the heterogeneously glycosylatedprotein into a single ˜20 kDa species. Proteins were separated bySDS-PAGE as previously described (see, Wadehra et al., Mol Biol Cell15:2073-2083 (2004), and Wang et al., Blood 97:3890-5 (2001)). Blotswere probed with anti-EMP2 or anti-β-actin followed by incubation with ahorseradish peroxidase-conjugated anti-rabbit or anti-mouse IgGantibody. Proteins were visualized by chemiluminescence (ECL; AmershamBiosciences, Piscataway, N.J.). Negative controls (secondary antibodiesalone) produced no signal. Experiments were repeated at least threetimes.

G. Lipid Raft Fractionation.

5×10⁷ cells were harvested, washed in PBS, and then resuspended inTris-buffered saline (50 mM Tris, pH 7.5, 20 mM EDTA, 10 μg/mlaprotinin, 10 μg/ml leupeptin, 1 mM phenylmethylsuflonyl fluoride, and 1mM Na₂VO₃. Cells were lysed by sonication (see, Wadehra et al., Mol BiolCell 15:2073-2083 (2004) and Moran et al., Immunity 9:787-96 (1988)) andthen dissolved in 1% Triton X-100 or 1% Brij 58 on ice for 60 min. Thesample was mixed 1:1 with 80% sucrose (40% final), followed by stepoverlays with 35 and 5% sucrose. The gradient was centrifuged at 46,000rpm for 18 h with a Sorvall SW55 rotor, and fractions (400 μl) werecollected from the top of the gradient. Samples were then solubilized inLaemmli buffer, treated with PNGase to remove N-glycans, and analyzed bySDS-PAGE. Cholesterol depletion was performed as described previously(see, Claas, C., et al., J Biol Chem 276: 7974-84 (2001)). Briefly,cells were washed in PBS to remove serum and then incubated in DMEMcontaining 20 mM methyl-β-cyclodextrin (Sigma) for 60 min at 37° C. Inorder to insure a lack of toxicity, cells were analyzed by trypan blueexclusion prior to harvesting. Samples were then treated as describedabove.

H. Statistical Analysis.

For the anti-EMP2 antibody and EMP2 peptide studies, groups wereanalyzed by two-tailed Student's paired t test, with a significancelevel of p≦0.05. The statistical significance of infection andattachment rate on stably transfected cells was tested using two-tailedtwo-sample equal variance t-test with a confidence level of p≦0.05.

Example 2 Localization of EMP2 to Lipid Rafts

To assess whether EMP2 is localized to lipid raft domains in endometrialcells (a Chlamydial host target), EMP2 was evaluated in the HEC1A humanendometrial cancer cell line by lipid raft fractionation with Brij 58and Triton X-100. In HEC1A cells, EMP2 localized to the light,detergent-resistant gradient fractions coinciding with GM1 ganglioside,a lipid raft component (FIG. 1 a,b). To confirm the localization of EMP2to lipid rafts, lysates were prepared in 1% Triton X-100 in the presenceor absence of methyl-β-cyclodextrins (MβCD) that selectively depletecholesterol from cellular membranes and causes loss of proteinlocalization into lipid rafts. In 1% Triton X-100, EMP2 localized toboth light, detergent-resistant fractions 3-4 as well as dense fractions6-7 (FIG. 1 c). When cells were incubated for 60 minutes with MβCD inserum free conditions, EMP2 expression completely shifted to soluble,dense fractions in the presence of 1% Triton X-100 (fractions 7-10).Repletion of cholesterol in MβCD-treated cells partially restored EMP2to the lipid raft fractions. These data indicate that, in HEC1A cells,EMP2 mainly resides within lipid raft microdomains, which are thought tobe the microanatomic target for Chlamydia-host cell interaction.

Example 3 Effect of Anti-EMP2 Antibody on Chlamydia Infectivity

The lipid raft localization of EMP2 in endometrial cells and its controlof lipid raft trafficking by integrins, caveolins, andglycosylphosphatidyl inositol-linked proteins (18, 20, 21), raised thepossibility that EMP2 might directly or indirectly affect Chlamydialinfectivity. To begin testing this hypothesis, anti-EMP2 antibody(specific for the 2nd extracellular loop of EMP2) was added to HEC1Acell cultures, then incubated with C. trachomatis, and infection wasmeasured (Chlamydial inclusions, expressed as ‘infection efficiency”, %inclusions relative to HEC1A cells without antibody treatment) (FIG. 2a). Anti-EMP2 antibody produced a dose-dependent inhibition of infectionefficiency (reaching less than 50% of HEC1A cells without antibody), atlevels that were highly significant compared to control antibody. Todetermine if the observed inhibition was due to EMP2 specificity,anti-EMP2 was pre-incubated with the relevant second extracellular loopEMP2 peptide, or a control peptide (first extracellular loop) (FIG. 2b). Pre-incubation of anti-EMP2 antibody with the specific EMP2 peptideneutralized the blocking effect of anti-EMP2 antibody, significantlyincreasing Chlamydia infection efficiency. In contrast, the controlpeptide at the same concentrations did not significantly increaseChlamydia infection in the presence of anti-EMP2. Thus, the anti-EMP2effect on Chlamydia infection reflected its specificity for the secondextracellular loop of EMP2.

Example 4 Efficiency of Chlamydia Infection with EMP2 Expression

As another experimental test, the efficiency of Chlamydia infection inendometrial cells was examined to see if it varied with EMP2 expression.HEC1A cell lines were stably transfected with expression plasmids tooverexpress an EMP2 fusion protein (HEC1A-hEMP2), suppress expression ofnative EMP2 via an EMP2-specific ribozyme (HEC1A-hRZ2), or a control GFPtransfectant (HEC1A-GFP) (FIG. 3 a). A recent quantitative study showedthat EMP2 levels in these overexpressing and ribozyme HEC1A sublineswere respectively 8.7-fold and 0.2-fold compared to GFP control cells(data not shown). The three HEC1A sublines were infected with C.trachomatis (FIG. 3 b), and Chlamydial infection was quantitated.Compared to control HEC1A-GFP cells, EMP2-overexpressing HEC1A-hEMP2cells had increased infection efficiency (145%, p<0.005). Reciprocally,EMP2-underexpressing HEC1A-hRV2 cells were impaired for infectionefficiency (49%, p<0.0001). Similar results were obtained using adistinct Chlamydia species, C. muridarum (MoPn) (FIG. 3 c). Compared toHEC1A-GFP, infection in HEC1A-hEMP2 cells was increased (167%, p<0.005),and in HEC1A-hRV2 was decreased (46%, p<0.0001).

Example 5 EMP2 Directly Mediates Chlamydia Attachment

The above findings indicated that Chlamydia infection efficiency wasdependent on the level of EMP2 expression, in a manner that could beblocked by anti-EMP2 antibody. While EMP2 might affect various stages ofthe infection process, one possible mechanism is that EMP2 acts at theinitial attachment step. To test this prediction, EMP2-divergent Hec1Asublines were incubated with Chlamydia EBs in the cold, and the numberof surface-attached EBs were quantitated. Compared to HEC1A-GFP, EBattachment in HEC1A-hEMP2 cells was increased (230%, p<0.0001).Reciprocally, attachment in HEC1A-hRV2 cells was decreased (70%,p<0.05). EB attachment was also inhibited by anti-EMP2 antibody.Compared to medium only, anti-EMP2 reduced EB attachment (50%, p<0.05);control antibody had no effect (FIG. 4 b). These finding indicate thatEMP2 directly affects EB attachment.

Example 6 Use of Phage Display Methodology to Obtain Antibodies

Phage display, first established by Smith et al in 1985, can provide anin vitro immune system useful in creating high affinity antibodies tovirtually any antigens with a bare minimal recognition region. Selectionof antibody using phage antibody libraries with filamentous phase andphagemids mimics humoral immune system that lack cell-mediatedresponses. Thus, generation of purified antibodies with affinitiescomparable to ones made by conventional hybridoma technology can beachieved without complications such as self-tolerance, T cell help andantigen presentation (see, Bradbury et al., J Immunol Methods 290:29-49(2004); Marks et al., Methods Mol Biol 248:161-76 (2004); Pavlik et al.,Hum Antibodies 12: 99-112 (2003); Persic et al., FEBS Lett 443:112-6(1999); and S. Smith, Science 228:1315-7 (1985)).

For the selection of antibodies against mouse and human epithelialmembrane protein-2 (mEMP2 and hEMP2 respectively), a purified phageantibody library expressing a single chain Fv(scFv) with the two Vregions linked with a flexible linker is used. V genes may be derivedfrom naturally rearranged V regions found in B-cells and scFv isexpressed on pIII, a bacteriophage coat protein.

20 amino acid sequences from the extracellular loop of mEMP2 and hEMP2such as previously used for polyclonal antibody production are chosenfor antigen targets for the phage display. Successful scFv isolationagainst 20-mer peptide has been previously reported. In order tomaintain natural conformation, these peptides are biotinylated at C- andN-termini with 4 amino acid long linkers (GSGS; SEQ ID NO.: 27). 3rounds of selection using streptavidin and avidin-coated beads arecarried out for each sample to isolate high affinity antibodies aspreviously described. Input and output concentrations of phage antibodylibraries and values for recovery and enrichment for each round arecalculated.

The specificity of selected antibodies is tested by ELISA, in which 95colonies picked from the isolated phage populations are incubated withbound mEMP2/hEMP2 peptides on streptavidin coated plates. Most ofcolonies may show a 4-5 fold increase in reactivity compared to control,indicating their high specificity against antigens. C-mEMP2 samples areused for further identification of anti-mEMP2 antibodies.

Of the highly reactive colonies, 14 colonies/sample are chosen for DNAfingerprinting and subsequent DNA sequence analysis. Protein expressionand purification systems are developed for each antibody using H iscontaining expression vectors, and testing the specificity and affinityof these antibodies is tested via Flow cytometry and Western Blot. Oncevalidity of these antibodies is confirmed, these scFvs are fused tointact Fc region containing C_(H)1, C_(H)2 and/or C_(H)3 domains toproduce intact chimeric antibody (see FIG. 5). Useful laboratory methodsfor performing the above are further disclosed in Bird et al., TrendsBiotechnol 9:132-7 (1991); Huston et al., Proc Natl Acad Sci USA85:5879-83 (1988); Wang et al., Blood 97:3890-5 (2001); Griffiths etal., Embo J 12:725-34 (1993); Kenanova et al., Cancer Res 65:622-31(2005); Slavin-Chiorini et al., Cancer Res 55:5957s-5967s (1995); and Xuet al., Cancer Res 60:4475-84 (2000).

The Fc-fused antibodies stabilize the antibodies, almost to a degree tonatural antibodies but also allow one to detect the antibodies withanti-Fc secondary antibodies conjugated with detectable markers. Thus,the development of these antibodies will provide strong biochemical andtherapeutic tools by producing highly purified stable anti-EMP2antibodies with increased specificity (see, Slavin-Chiorini et al.,Cancer Res 55: 5957s-5967s (1995); and Xu et al., Cancer Res 60:4475-84(2000)).

Example 7 Use of an Anti-EMP2 Diabody to Prevent, Reduce or TreatChlamydia Infections in the Female Genital Tract (FGT)

EMP2 is a transmembrane protein in the GAS-PMP22 family with 4transmembrane domains and two extracellular loops (FIG. 6A). EMP2 isexpressed in murine and human epithelial cell lines. EMP2 is expressedwithin the murine reproductive tract and ovaries and mediates blastocystimplantation via αVβ3 integrin. In order to extend our in vitro studiesto an in vivo model of Chlamydia genital infection, an anti-EMP2antibody was generated that could be purified to homogeneity.Recombinant monoclonal antibodies against EMP2 were created using a 24amino acid sequence from the small extracellular loop of murine EMP2(FIG. 1A), the area previously used to create the polyclonal antibodyused in our report (Shimazaki et al., Microbes Infect 9:1003-10 (2007)).Recombinant monoclonal antibodies have been shown to have peptideaffinities comparable to ones made by conventional hybridoma technology,but can be achieved without complications such as self-tolerance, T cellhelp and antigen presentation (Bradbury & Marks, J Immunol Methods290:29-49 (2004)).

In order to select for antibodies against mouse EMP2, a purified phageantibody library expressing a single chain Fv(scFv) with the two Vregions linked with a flexible linker was used (gift from Dr. James D.Marks) (Bradbury & Marks, J Immunol Methods 290:29-49 (2004)). Thisresulted in a diabody molecule directed against mouse EMP2 (EMP2diabody) as shown in FIG. 6B.

Several molecularly-independent clones were observed to have highaffinity for mouse EMP2 by ELISA (>5 fold) and five independentdiabodies or recombinantly engineered divalent antibody fragments, werecreated, four with specificity against EMP2 (KS41, KS49, KS83, KS89),and a control diabody that does not recognize EMP2 (A10). Thespecificity of these diabodies, both reactivity against EMP2 for the KSseries and no reactivity against EMP2 for the control A10 were verifiedby ELISA against the specific peptide used to select the antibody and byflow cytometry using cells that are known to either express EMP2 or lackEMP2 expression. FIG. 7 shows a representative flow cytometryconfirmation of reactivity.

Masking EMP2 Reduces the Local Bacterial Load of Chlamydia muridarum(MoPn) In Vivo.

We have recently reported that preventing the ligation of EMP2 or anassociated complex on a variety of host cells in vitro with MoPnsignificantly blocked the organism's ability to infect various celllines (Shimazaki et al., Microbes Infect 9:1003-10 (2007)). Whetherblocking EMP2 on epithelial cells in the murine FGT could affectsubsequent bacterial burden in vivo was next investigated. Mice weresynchronized by administering progesterone by subcutaneous injection of2.5 mg/mouse Depo-Provera 7 days prior to infection. This treatment isnecessary in mice to avoid keratinizing epithelial cells and facilitateMoPn infectivity. Groups of mice were either vaginally pretreated withan anti-EMP2 diabody, a control diabody or the vehicle alone, PBS, for20 minutes and then infected by vaginal deposition of 1.5×10⁵ infectiousforming units (IFU) C. muridarum (MoPn). As can be appreciated in FIG.8A, a single pretreatment with a small amount of anti-EMP2 diabodysignificantly reduced initial infection levels in the FGT as determinedfrom vaginal swabs taken every 3rd day. Tissue was collected from 3regions of the FGT; oviducts (OD), uterine horns (UH) andcervical-vaginal (CV) region which includes the endocervix as previouslydescribed. Examination of bacterial burden in FGT regions revealed asignificant decrease in MoPn levels compared to mice pretreated withcontrol diabody. Further, pretreatment with anti-EMP2 diabody reducedascending infection since the majority of anti-EMP2 diabody treated micewere negative for MoPn (FIG. 8B).

EMP2 is expressed on epithelial cells of the murine FGT in vivo(Shimazaki et al., Microbes Infect 9:1003-10 (2007); Wadehra et al., DevBiol 287:336-45 (2005)) and ligation with anti-EMP2 diabody may reduceinfectivity by modulating EMP2 expression. To determine whetherpretreatment with anti-EMP2 modulates expression within the FGT,immunohistochemical staining (IHC) staining was next performed. As shownin FIG. 9, mice vaginally pretreated with anti-EMP2 diabody showedreduced and altered expression of EMP2 using IHC detection of EMP2within formalin-fixed, paraffin-embedded sections of FGT compared tocontrol diabody treated mice. Vaginal pretreatment with anti-EMP2diabody (KS83) reduced the overall expression of EMP2 on epithelialcells as compared to epithelial cells from control diabody pretreatedmice (FIG. 9). The diabody was able to reach the oviducts (OD) as EMP2pretreatment also reduced expression on epithelial cells, however theova which are adjacent to oviduct tissue serve as a positive internalcontrol as they intensely express EMP2 (FIG. 9E inset, arrowhead) evenin anti-EMP2 diabody pretreated mice. Interestingly, anti-EMP2 treatmentreduced expression on the apical surface of epithelial cells (FIGS. 9C &D, arrows).

Immune Parameters are Reduced by Blocking the Interaction of EMP2 withMoPn.

Pretreatment with anti-EMP2 diabody was also able to reduce activationof the local immune response reflecting a reduction in vaginalinfection. The cytokine IFNγ is secreted by CD4, CD8 and NK cells whichappear in GT tissue shortly after infection (Maxion et al., Infect Immun72:6330-40 (2004); Darville et al., Infect Immun 69:3556-61 (2001)).Expression of IFNγ by ELISA was examined using a commercially availablekit (eBioscience) in homogenized regions of the GT obtained 4 days afterpretreatment and infection as described above. As shown in FIG. 10,analysis revealed a significant decrease in IFNγ protein levels in theCV and UH regions, markedly diminished levels within the OD andsuggesting that cells secreting IFNγ were reduced in number in micepretreated with EMP2 diabody.

Fewer leukocytes ought to be present in the FGT of mice pretreated withan anti-EMP2 diabody to reflect the reduction in bacterial burden anddecrease in local IFNγ protein levels. Accordingly, the number ofpolymorphonuclear (PMN) cells in pretreated mice early after infectionwas evaluated. Briefly, mice were pretreated with anti-EMP2, diabodycontrol or vehicle and infected as above. Early after infection (4days), FGT tissues were collected and stained for cell surface markersof immune cells. As shown in FIG. 11, diminished numbers of PMN(Ly6G/C+CD3−CD4−) were observed, particularly in the OD of the FGT. Thisobservation confirms the ability of anti-EMP2 diabody treatment toreduce MoPn tissue burden and IFNγ levels in vivo which results indiminished numbers of accumulating leukocytes. Taken together, theresults show that pretreatment of mice with anti-EMP2 diabodiessignificantly reduces the ascending bacterial burden and inflammatoryresponse in the FGT following infection with C. muridarum. Accordingly,masking EMP2 in individuals should reduce C. trachomatis genitalinfection and pelvic inflammatory disease and sexual transmission.

Our laboratory recently found that progesterone treatment results inincreased EMP2 surface expression (data not shown) and pretreatment ofmice with progesterone is understood to increase the susceptibility toinfection in vivo. The effect on surface expression of EMP2 ofprogesterone therapy in vivo was next tested.

Ovariectomized female mice were treated with daily injections of 100 ngper mouse of 17β estradiol or 1 mg per mouse of progesterone dissolvedin 100 μL of sesame oil, or sesame oil alone (Sigma). Mice wereeuthanized at various time points and genital tracts were processed forIHC using mEMP2 antisera or control rabbit serum. Tissue blocks wereimmunostained using an antigen retrieval technique according topublished protocol, and rabbit polyclonal antibodies generated againstmouse EMP2 were previously described (Wang et al., Blood 97:3890-3895(2001)). In ovariectomized mice EMP2 is not detected byimmunohistochemistry, however treatment with progesterone or estradiol,induces expression of EMP2 on the endoplasmic reticulum and golgi of theluminal and glandular epithelium at 3 days (FIG. 12). Expression isobserved on the apical plasma membrane at an earlier time point (notshown). Taken together, these data support a novel approach, GT tissuepretreatment with anti-EMP2 to reduce MoPn genital infection.

Example 8 Effect of Treatment with Anti-EMP2 Diabodies on EndometrialAdenocarcinoma Cells

In this study, recombinant human anti-EMP2 diabodies were developedusing filamentous bacteriophage library methodology, and assessed theefficacy of these diabodies in growth, apoptosis, and xenograft tumorformation by EC cell lines. Diabody avidity and specificity for EMP2peptide and native protein were confirmed by ELISA and flow cytometryusing multiple cell lines. Biologically, treatment of various humanendometrial adenocarcinoma cell lines with these anti-EMP2 diabodiesresulted in a significant increase in caspase-dependent apoptotic celldeath in vitro, and reduced tumor volume and viability in vivo. Theresults indicate that EMP2 is a targetable molecule for pharmacologicalinduction of apoptosis in EC cell lines.

It is notable that a human immunoglobulin gene library permittedsuccessful production of anti-human EMP2 antibodies. While theseantibodies in effect detected a self-antigen, they should not beconstrued as a native autoimmune specificity, since the combinatoriallibrary permits the creation of VH/VL pairings that may not have beenrepresented in the native clonal populations (Marks et al., Methods MolBiol 248:161-76 (2004)). Conversely, the direct yield of humanimmunoglobulin reagents with such biologic activity avoids thecomplexity of reengineering non-human epitopes while retaining antigenspecificity and avidity in rodent-derived reagents (Wu et al.,NatBiotechnol 23:1137-46 (2005)).

Successful therapeutic targeting of antibodies depends on tissuepenetration and uptake, rapid blood clearance, and serum stability.Small antibody fragments such as scFv have rapid tissue penetration andfast clearance from the circulation, but as monovalent reagents arelimited by low binding affinity and avidity (Adams et al., Cancer Res53:4026-34 (1993); Colcher et al., Q J Nucl Med 42:225-41 (1998);Milenic et al., Cancer Res 51:6363-71 (1991); Yokota et al., Cancer Res52:3402-8 (1992)). Accordingly, we engineered selected anti-EMP2 scFvfragments into bivalent diabodies, which are known to have an increasedavidity and stability, by shortening the linker region of scFv's betweenheavy chain variable region (V_(H)) and light chain variable region(V_(L)) (Holliger et al., Nat Biotechnol, 23:1126-36 (2005); Nielsen etal., Cancer Res 60:6434-40 (2000)), SDS-PAGE and size exclusion FPLCdata confirmed successful diabody formation with >95% purity,and >20-fold increase in binding activity compared to original scFvs.

FACS analysis of anti-hEMP2 and anti-mEMP2 diabodies demonstratedsimilar binding activity to native surface EMP2. This was specific forEMP2, since it was dependent on levels of native or engineered EMP2expression. Interestingly, whereas anti-hEMP2 and anti-mEMP2 diabodieswere species specific for isolated peptides by ELISA, they showedcross-species reactivity for cell surface human and mouse EMP2. Itshould be noted that the selecting hEMP2 and mEMP2 peptide antigensshared 90% sequence similarity and 50% sequence identity. Thus, the keycontact residues for this set of anti-EMP2 diabody clones may target thespecies-conserved homologous peptides. Why might this crossreactivity bedetected with the native protein, but not the isolated peptide. First,typical for tetraspan proteins, we predict that native EMP2 exists as amultimer on the membrane. This would increase the avidity of diabodybinding compared to isolated peptide in ELISA format. Second, in thenative protein, the EC2 domain (containing the target peptide) exists asa constrained loop, which due to sequence homology is likely to adopt asimilar conformational display. In contrast, free peptide in the ELISAformat will represent a set of random peptide conformations. It is thusconceivable that the homologous loop conformation of the hEMP2 and mEMP2would result in closer binding affinity of the different species foreach diabody. The strong cross-species homology of the EC2 peptide, andthis apparent topological display suggest that this epitope may bebiologically important for the native function of EMP2.

Anti-EMP2 diabody treatment exhibited significant anti-proliferativeeffects by increasing caspase 3-related apoptosis in multipleendometrial adenocarcinoma cell lines. These effects on cell growthinhibition and apoptosis correlated with EMP2 expression levels ofindependent cell lines, suggesting that binding of EMP2 inducedapoptosis signaling. In support of this idea, progesterone induction ofEMP2 expression increased diabody-mediated cell death in RL95-2 cells.Alternatively, recent data has shown that intravaginal injection ofanti-EMP2 diabody in the murine genital tract dramatically reduced EMP2expression in native endometrial epithelium (Shimazaki et al., MicrobesInfect 9:1003-10 (2007)). It should be noted that EMP2 exists in aphysical complex with FAK and certain integrin isoforms and promotesFAK-Src activation (Morales et al., FAK-Src Regulated PVR Response isEMP2 Dependent, Submitted 2008). Since divergent signaling pathways areinduced by integrin ligation, it is conceivable that apoptosis may befavored in the absence of FAK (Mould et al., CurrOpinCell Biol 16:544-51(2004); Renshaw et al., J Cell Biol 147:611-8 (1999); Zhao et al., JCell Biol 143:1997-2008 (1998)).

In order to determine the preclinical applicability of targeting EMP2,toxicity experiments were initially performed. It is known that thehighest levels of EMP2 occur in the lung, skin, and female reproductivetract (Wang et al., Blood 97:3890-5 (2001); Ben et al., Genomics,49:443-7 (1998)). Importantly, anti-EMP2 diabody treatment exhibitedminimal toxicity as measured by weight loss, liver function, and changesin histology when administered systemically over a two week time frame.Furthermore, the reduction in tumor volume for both HEC-1A/V andHEC-1A/OE cells with anti-EMP2 diabodies suggest that targeting EMP2 maybe a successful for treatment. Interestingly, HEC-1A/V cells whichexpress modest levels of EMP2 on the plasma membrane in culture, in vivoexpressed levels of EMP2 comparable to HEC-1A/OE generated tumors.Consequently, HEC-1A/V cells responded significantly to anti-EMP2diabody treatment.

Apoptosis can involve activation of diverse caspase isoforms, dependingon the death receptor-mediated and mitochondrial pathways of apoptosisinduction (Rupinder et al., Vascul Pharmacol, 46:383-93 (2007)). In thisstudy, caspase 3 activation was assessed, since it is the downstreamevent of all of these pathways (Rupinder et al., Vascul Pharmacol,46:383-93 (2007)). We note that EMP2 is important for integrinexpression and function, and also modifies surface display of GEMs andtheir associated membrane proteins (see Introduction). Accordingly, EMP2may modulate integrin-dependent signaling associated with survivalsignaling, or by other GEM-associated receptors. For example, K-ras andHER-2/neu has been identified as an EC-associated oncogene that stablyinteracts with the plasma membrane and regulates activation of selectivesignaling pathways via lateral diffusion and interaction with othermolecules (Enomoto et al., Diagn Mol Pathol 3:292-7 (1994); Enomoto etal., Cancer Res, 53:1883-8 (1993); Niv et al., J Cell Biol 157:865-72(2002)). Thus, several lines of investigation might be pursued todetermine mechanism by which anti-EMP2 diabodies elicit apoptosis.

The above results were achieved employing the following methods:

A. Cell Lines.

The human endometrial adenocarcinoma cell line HEC-1A (HTB112, ATCC,Manassas, Va.), RL95-2 (CRL 1671, ATCC), Ishikawa (gift of Dr. MarkPegram, UCLA), and mouse embryonic fibroblast cell line NIH 3T3(CRL-1658, ATCC) were cultured in appropriate media supplemented with10% fetal calf serum at 37° C. in a humidified 5% CO₂ and passaged every7 days. In addition to HEC-1A wild type cells (HEC-1A/WT), HEC-1Asublines were prepared to increase or decrease EMP2 expression usingexpression plasmids for a human EMP2-GFP fusion protein and control GFP(Wadehra et al., DevBiol 287:336-45 (2005)). These sublines were termedHEC-1A/OE, HEC-1A/V, respectively. EMP2 expression levels in each cellline were determined by Western blot analysis.

B. Phage Library Selection.

Phage library selection was carried out as previously described (Blazeket al., J Virol Methods 115:83-92 (2004)). Briefly, 10¹²-10¹³ phage fromthe 8.2×10⁸ member phagemid library were first pre-depleted with 100 μLof streptavidin magnetic beads (Invitrogen, Carlsbad, Calif.) in 2% milkPBS for 1 hour at room temperature. The pre-depleted phage library wasthen mixed with 10 μg of biotin conjugated 24 amino acid peptidescorresponding to the extracellular loop of human and mouse EMP2 (SEQ IDNO.: 28 SEQ ID NO.: 42 DIHDKNAKFYPVTREGSYGGSGSK and SEQ ID NO.: 29DLHQQNRKLYYLLQEGSYGGSGSK respectively) (Wang et al., Blood 97:3890-5(2001)) for 1 hour at room temperature. 100 uL of 2% milk PBSpre-blocked streptavidin magnetic beads were added to the phage mixtureand rotated for 15 min at room temperature. Beads were washedextensively with 0.1% PBS/Tween, 2% milk PBS, and finally with PBS, andbound phage was eluted out with 1 mL of 100 mM triethylamine,neutralized with 500 ul of 1M Tris-HCl pH 7.4, and added to 10 mL ofexponentially growing E. coli TG1. Culture was then plated on 150 mmculture plates with 2× TY 100 μg/ml ampicillin, 2% glucose agar plates(2× TY/amp/glu) overnight at 37° C. The next day, colonies were scrapedfrom the plates and used to amplify the phage for the second round ofselection described above. A total of three selections were performedbefore screening and characterization of the selected phage antibodies.

C. Diabody Construction and Production.

Binding specificity of expressed single chain Fv (ScFv) was analyzed byEnzyme-Linked ImmunoSorbent Assay (ELISA) as previously described (Markset al., Methods Mol Biol 248:161-76 (2004)) (see ELISA section below fordetails). Single chain Fv clones with high reactivity were selected forthe construction of diabodies. A number of different ScFv clones werecharacterized and confirmed by DNA fingerprinting (Gussow et al.,Nucleic Acids Res 17:4000 (1989); Marks et al., J Mol Biol 222:581-97(1991)) and DNA sequencing (Schier et al., J Mol Biol 255:28-43 (1996)).pHEN phagemids from selected phage were isolated using QIAprep SpinMiniprep Kit (Qiagen, Valencia, Calif.). Single chain Fv inserts werethen digested and cloned into pSYN I vector in frame with a c-Myc and 6His (SEQ ID NO.: 30) tag at the C-terminus. In order to convert ScFvfragments into diabody, 15 amino acid linker region(AGTGGTGGAGGCGGTTCAGGCGGAGGTGGCTCTGGCGGTGGCGGATCG; SEQ ID NO.: 31) ofthe ScFv was shortened into 5 amino acid linker (AGTGGTGGAGGATCG; SEQ IDNO.: 32) using QuikChange site-directed mutagenesis kit (Stratagene, LaJolla, Calif.) (Adams et al., Br J Cancer 77:1405-12 (1998)). Deletionmutation was confirmed by DNA sequencing analysis.

Expression and purification of the selected diabodies were carried outusing a modified protocol described by Marks et al. (Marks et al.,Methods Mol Biol 248:161-76 (2004)). Single colonies were picked fromthe plate, inoculated into 1 L/colony of 2×TY with 100 μg/mL ampicillin(2×TY/amp) at 250 rpm at 37° C. When A₆₀₀ reached 0.8-1.0, proteinexpression was induced by addition of 1 mM IPTG. The culture was shakenat 120 rpm at 30° C. for 4 hours and spun at 7000 rpm for 15 min at 4°C. Pellets were then re-suspended in 20 mL of periplasmic buffer (200 mMTris-HCl, 20% sucrose, 1 mM EDTA, pH 7.5), and 290,000 units of lysozyme(Epicentre, Madison, Wis.) was added to each mixture. The mixtures wereincubated at room temperature for 5 min and spun at 7000 rpm for 15 minat 4° C. The pellets were then re-suspended with 20 ml of 40 mM MgSO₄and left on the ice for 10 min. The samples were spun again, and thesupernatants from this spin were combined with the first supernatants.The mixture was then filtered with 0.45 μm filters, and dialyzed indialysis buffer (300 mM NaCl, 20 mM HEPES, pH 8.0) overnight at 4° C.Next morning, the samples were filtered again with 0.2 μm filters andrun through 5 mL of the Ni-NTA column (Qiagen). The column was washedwith 20 mL wash buffer (300 mM NaCl, 20 mM imidazole, 20 mM HEPES, 0.05%Tween, pH 8.0), and bound diabodies were eluted with 5 ml elusion buffer(300 mM NaCl, 250 mM imidazole, 20 mM HEPES, pH 8.0), dialyzed inendotoxin free PBS overnight at room temperature. Samples were filteredwith 0.22 μm filters, and stored at −20° C. until their use. Purity ofthe preparation was determined by size exclusion chromatography profile(FPLC; Superdex 75, Amersham Pharmacia Biotech, Uppsala, Sweden) asnecessary.

For preparative analysis of the diabody, purified diabody preparationswere run on 4-20% Tris-Glycine gel (Invitrogen) and bands werevisualized using GelCode Blue Stain Reagent (Pierce, Rockford, Ill.).Gels were scanned and the band intensities were analyzed using the ImageJ program (National Institute of Health, Bethesda, Md.).

D. Enzyme-Linked Immunosorbent Assay (ELISA).

10 μg/mL of biotinylated 24 amino acid peptide (see the phage libraryselection section above) was coated onto streptavidin-coated 96-wellplates (Roche Applied Science, Indianapolis, Ind.) in PBS for 1 hour atroom temperature. Plates were then washed with PBS and blocked with 2%milk PBS for 2 hours at 37° C. Expressed phage antibodies or diabodieswere added to each well, incubated at room temperature for 1 hour, andwashed with 0.05% PBS/Tween three times. Bound antibodies or diabodieswere detected with mouse anti-c-Myc (9E10) antibody (Calbiochem, SanDiego, Calif.), followed by horseradish peroxidase (HRP) conjugatedanti-mouse antibody (BD Bioscience Pharmingen, Franklin Lakes, N.J.) andTMB solution (eBioscience, San Diego, Calif.). Plates were read bymicroplate reader Model 550 (Bio-Rad, Hercules, Calif.) at 450 nm.

E. Fluorescent Activated Cell Sorting (FACS) Analysis.

Cells were detached from a flask with 2 mM EDTA, spun at 1000 rpm for 3min, and re-suspended with BD Cytofix/Cytoperm solution (BD BiosciencePharmingen) to final concentration of 1×10⁷ cells/mL. Cells were washedwith BD Perm/Wash buffer (BD Bioscience Pharmingen), followed by a 30min incubation with BD Perm/Wash buffer containing 2% BSA on ice. Afterspinning at 2000 rpm, cells were resuspended with BD Perm/Wash buffercontaining 1 μg of purified monoclonal diabody in 96 well plates on icefor 1 hour. Cells were then washed with 200 μL of BD Perm/Wash bufferthree times. Bound monoclonal diabodies were detected with mouseanti-c-Myc (9E10) antibody (Calbiochem), followed by R-PE conjugatedanti-mouse secondary antibody (BD Bioscience Pharmingen).

G. Serum Stability Assay.

Diabody preparations were diluted in 200 μL of human or mouse serum to afinal concentration of 5 μg/mL and plated in a 96 well plate. The platewas incubated at 37° C. for 15 min, 24 hours, 48 hours, or 72 hours.Samples were collected, and the diabody serum stability was determinedvia ELISA method described above.

H. Cellular Cytostasis.

5×10⁴ cells were incubated in 96 well plates with 0-25 μg/mL diabody. At0 and 24 hours, cells were stained with toluidine blue, and then lysedin 2% SDS (Biowhittaker, Walkersville, Md.). The number of cells at eachtimepoint was quantitated in triplicate by the absorbance at 595 nm, andthe standard error of the mean was calculated. Each experiment wasrepeated at least three times.

I. Cell Death Analysis.

For cell death analysis, cells (5×10⁵) were incubated in 6-well platesin 10% FCS medium. Cells were incubated with 12.5 μg/ml diabody A10(control), KS49, or KS83 for 72 hrs. For hormone treatment, RL95-2 cellsat 60-70% confluence were washed in PBS, and subsequently incubated withprogesterone (Sigma., St. Louis, Mo.) in treatment medium (DMEM/Ham'sF-12 supplemented with 0.5% charcoal-stripped FBS (Omega Scientific,Tarzana, Calif.), 1% penicillin-streptomycin, and 1% L-glutamine).Progesterone was and added to treatment medium at 25 μM as previousdescribed (Wadehra et al., Reprod Biol Endocrinol 6:15 (2008)). Cellviability was determined by trypan blue exclusion.

To determine the rate of apoptosis, cells were stained with annexin V(Becton Dickinson Biosciences, Torrey Pines, Calif.) and7-aminoactinomycin D (7AAD) or propidium iodide. Cells were harvested at24-48 hours after diabody treatment as indicated in the figure legends.The cells were incubated for 15 minutes on ice with annexin V-Cy3 and7AAD as per manufacturer's instructions, and analyzed on a flowcytometer (Becton Dickinson Biosciences).

J. Caspase 3 Activity.

Cells were incubated as above and harvested 48 hours after diabodytreatment. Samples were normalized based on cell number and lysed byboiling for 5 minutes in Laemmli buffer (62.5 mM Tris-Cl, pH 6.8, 10%glycerol, 2% SDS, 0.01% bromophenol blue, 2% βME). The lysate wasseparated on a 12% SDS-polyacrylamide gel and transferred to anitrocellulose membrane (Amersham Pharmacia). Membranes were incubatedwith 10% milk in PBS containing 0.1% Tween-20. An anti-caspase 3 mousemonoclonal antibody, 2 ng/μL final concentration (BD Biosciences), oranti-fl-actin (Sigma) was added and incubated for 1 hour. The membranewas washed 3 times with PBS/Tween-20 and then incubated for 45 minuteswith a horseradish peroxidase-labeled secondary antibody (goatanti-mouse immunoglobulin G [IgG] or goat anti-rabbit IgG, 1:2000dilution; Jackson ImmunoResearch Laboratories, West Grove, Pa.).Proteins were detected by chemiluminescence (Amersham Pharmacia).

K. Native Tissue Toxicity.

Six to eight week old female wildtype (C57BL/6) mice were obtained fromJAX Laboratories. Animals were inoculated intravenously with increasingconcentrations (0.5-5 mg/kg) of A10 diabody control, anti-EMP2 diabodies(K83, K49), or a vehicle control (sterile PBS). Three mice were utilizedper group and were injected twice a week. After 14 days, serum wascollected, and mice were euthanized by cervical dislocalization. Tissue(kidney, liver, spleen, lung, skin) were collected and fixed informalin. Samples were processed by the Tissue Procurement Laboratory atUCLA. Toxicity in tissue was assessed using hemotoxylin and eosin andvalidated by a pathologist. Serum alanine aminotransferase (ALT) anddirect and total bilirubin were assessed by the UCLA Medical CenterClinical Laboratories.

L. Tumor Xenografts and Treatment.

Four to six-week-old nude BALB/c female mice were obtained from CharlesRiver Laboratories (Wilmington, Mass.) and maintained at the Universityof California, Los Angeles in accordance with IRB procedures. Animalswere inoculated s.c. with 1×10⁶ HEC-1A/V and HEC-1A/OE cells into theright and left shoulder flanks. Once tumors reached 2-3 mm (largestdiameter, day 13), tumors were injected biweekly with 1 mg/kg anti-EMP2diabody 83, control diabody 10, or a vehicle control (sterile saline)for up to three weeks. Six mice were utilized per group. Tumors weremeasured every 3-4 days using vernier calipers, and tumor volumes werecalculated by the formula π/6× larger diameter×smaller diameter (Agus etal., Cancer Res 59:4761-4 (1999)). At day 30, tumors were excised andfixed in formalin. Tumors were processed for hemotoxylin and eosinstaining by the Tissue Procurement Laboratory at UCLA. In addition, somesections were stained for EMP2 expression as outlined below.

M. Immunohistochemistry.

The expression of EMP2 in paraffin fixed tissue has been previouslydescribed (Wadehra et al., Cancer 107:90-8 (2006)). Briefly, sectionswere processed for antigen retrieval by incubating slides at 95° C. for20 minutes in 0.1 M citrate, pH 6.0. Sections were stained using primaryhEMP2 antiserum (1:400) or the corresponding preimmune control at thesame dilution overnight at 4 C. The antibody signal was detectedaccording to the manufacturer's instructions using the Vectastain ABCkit (Vector Labs, Burlingame, Calif.). EMP2 expression was visualizedusing diaminobenzidine. Nuclei were counterstained using hemotoxylin.

N. Statistical Analysis.

For the ELISA analysis, groups were analyzed by two-tailed Student'spaired t-test at a 95% confidence level. Differences in the in vitroanti-proliferative and in vivo effects of diabodies were evaluated usingStudent's unpaired t-test at a 95% confidence level (GraphPad Prismversion 3.0; GraphPad Software, San Diego, Calif.).

The following experimental results were obtained:

A. Construction and Expression of Anti-EMP2 Diabodies.

Anti-EMP2 scFv was isolated using phage library expressing 8.2×10⁸variable scFv as previously described (Blazek et al., J Virol Methods115:83-92 (2004)). EMP2 specific scFv were selected using 24 aminoacid-long peptides that represent second extracellular domain (ECD) ofhuman (hEMP2) and mouse EMP2 (mEMP2). Fourteen clones were identified byhEMP2 ELISA, and of these, three independent clones were found to beindependent by sequence features. Three independent clones wereconstructed and produced as diabodies; all were positive by ELISA, andone (KS49) was positive by flow cytometry for native EMP2 binding (seebelow). Fourteen clones were identified by mEMP2 ELISA, and of these,three independent clones were found to be independent by sequencefeatures. Three independent clones were constructed and produced asdiabodies; all were positive by ELISA, and one (KS83) was positive byflow cytometry for native EMP2 binding. As negative controls, two randompre-selection scFvs were chosen (A10 and B3): none were positive byELISA with hEMP2 or mEMP2 in either the scFv or diabody format.

For the present study, KS49 and KS83 were chosen as representative scFvfor hEMP2 and mEMP2, respectively. Two random pre-selection scFv, A10and B3, were used as negative control antibodies. In order to increasethe avidity of the selected scFv, we created divalent diabodies byshortening the scFv linker region to 5 amino acids (FIG. 15A) (Adams etal., Br J Cancer 77:1405-12 (1998)). Diabodies were expressed in TG1 E.coli and purified as previously published (see Methods).

B. SDS-PAGE and Size Exclusion FPLC Analysis of Purified Anti-EMP2Diabodies.

Analysis of purified diabody proteins by SDS-PAGE in a reducingcondition showed a single band around 25 kDa, which corresponds to anappropriate size of scFv or diabody monomer (FIG. 15A) (Olafsen et al.,Protein Eng Des Sel 17:21-7 (2004)). Size exclusion chromatography alsodemonstrated the formation of a dimer with a protein retention time at20.23 min (average of two experiments), matching with the expected sizeof the diabody (FIG. 15B) (Olafsen et al., Protein Eng Des Sel 17:21-7(2004)). Both data indicated >95% purity of the prepared diabodysamples.

C. Antigen Specificity of Anti-EMP2 Diabodies.

Specificity and titer of selected diabodies were initially tested byELISA using plates coated with hEMP2 or mEMP2 peptides. KS49, a diabodyselected against hEMP2 peptide, showed significant binding to hEMP2,whereas binding to mEMP2 was below detection (data not shown).Reciprocally, KS83, a diabody selected against mEMP2 peptide, showedhigh reactivity to mEMP2 peptide, whereas reactivity to hEMP2 peptidewas below detection (data not shown). Negative control diabodies A10 andB3 demonstrated minimal reactivity to either hEMP2 or mEMP2 peptides. Asshown in FIGS. 15C and D, diabody titration analysis showed adose-dependent binding of the KS49 and KS83 to the hEMP2 and mEMP2antigens respectively. KS49 and KS83 efficiently bound to theirappropriate antigen with EC₅₀ (the antibody concentration at which 50%of maximum binding occurs) of 53.1 ng/mL and 9.32 ng/mL, respectively.Using monovalent scFv products of these two antibodies, the EC₅₀ forcognate EMP2 peptide was >2 μg/mL (data not shown). Thus, divalencycontributed to the avidity of the two anti-EMP2 diabodies.

Binding activity of diabodies was further assessed by FACS analysisusing human endometrial adenocarcinoma cell lines RL95-2, Ishikawa, andthe murine fibroblast cell line NIH 3T3, all of which are known toexpress EMP2 (representative data shown in FIG. 16). Both KS49 and KS83showed significant reactivity against all three cell lines regardless ofthe difference in host species. This species cross reactivity mayreflect the close homology between human and mouse EMP2 secondextracellular domains (50% sequence identity and 90% sequencesimilarity; see Methods). Control diabodies A10 and B3 showed minimaldetection against all cell lines, confirming the specificity of theanti-EMP2 diabodies against EMP2 proteins.

Diabody Stability in Serum.

One of the practical usages of diabodies is therapeutic targeting ofcancer tumors (Cochlovius et al., J Immunol 165:888-95 (2000)). In orderto assess the stability of anti-EMP2 diabodies in physiologicalcondition, 5 μg/mL of diabodies were incubated in either human or mouseserum at 37° C. for 15 min, 24, 48, and 72 hours. The retained stabilitywas measured using an ELISA. The binding activity of the diabody wasmaintained over the 72 hour-period in both human and mouse serum (datanot shown). The specificity, which was detected using relevant andirrelevant peptide antigens, was also retained for the prolongedincubation period.

Antibodies to EMP2 Inhibit Cellular Growth.

To determine if selective targeting of EMP2 may be an effective therapyin EC, the endometrial adenocarcinoma cell lines RL95-2, Ishikawa, andHEC-1A-WT were utilized. Cells were treated with KS49, KS83, or thecontrol diabody A10 (FIG. 17). Compared to control diabody, anti-EMP2diabodies induced cellular cytostasis within 24 hours. When cells wereincubated with a range of recombinant antibody from 0-25 μg/mL, therecombinant clones KS49 and KS83 had a dose-dependent,anti-proliferative effect on the endometrial cell lines RL95-2 andIshikawa (FIGS. 17A and B). In contrast, diabodies against EMP2exhibited small effects on HEC-1A-WT cells, which have been shown tobear little EMP2 on the plasma membrane (Wadehra et al., DevBiol287:336-45 (2005)). Previous studies have characterized HEC-1A/OE cellswhich overexpress EMP2 as a GFP fusion protein (Wadehra et al., DevBiol292:430-41 (2006); Wadehra et al., DevBiol 287:336-45 (2005)). In thesecells, EMP2 protein levels are increased approximately 4 fold (FIG.17C). Strikingly, diabodies KS83 and KS49 significantly inhibited growthof HEC-1A/OE cells by 55% and 21%, respectively, over cells treated withthe control diabody A10 (FIG. 17).

F. Diabodies to EMP2 Induce Apoptosis.

To correlate the decrease in cell number with an increase in cell death,cells were assessed for apoptotic cells using flow cytometry.Endometrial carcinoma cell lines were treated with 12.5 μg/mL KS49,KS83, or control A10 diabodies for 24 hours. Apoptotic cells weredetected with annexin V and 7-AAD and analyzed by flow cytometry.Anti-EMP2 diabodies induced pronounced cell death in RL95-2 cells (FIG.18A). Small effects were seen in HEC-1A-GFP cell lines, but cell deathwas enhanced by overexpression of EMP2 (HEC-1A/OE) (FIGS. 18B and C).Thus, anti-EMP2 diabodies specifically increased apoptosis, in a mannerassociated with increased EMP2 surface expression.

G. Synergistic Effects of Progesterone.

RL95-2 expresses functional PR-A and PR-B receptors, and theirexpression of EMP2 is regulated by progesterone (Wadehra et al., ReprodBiol Endocrinol 6:15 (2008)). As progesterone increases EMP2 expression,we predicted that progesterone treatment may enhance the rate ofanti-EMP2 diabody mediated apoptosis in RL95-2 cells as these cellsexpress functional progesterone receptors (Myers et al., J ClinEndocrinol Metab, 86:2323-6 (2001); Schneider et al., J Soc GynecolInvestig 5:334-8 (1998)). Cells were stained with annexin V andpropidium iodide and analyzed by flow cytometry. Dramatically, thecombination of progesterone (P4) and KS49 or KS83 treatment increasedthe number of annexin V, propidium iodide positive cells by 16.5% and19% respectively compared to cells treated with diabody alone (FIG.19A).

To confirm that combination progesterone and EMP2 specific diabodiesincrease cell death over diabody treatment alone, cells were analyzed bytrypan blue exclusion 72 hours after treatment (FIG. 19B). Progesteroneand KS83 or KS49 significantly increased cell death over progesteroneand control diabody A10 treatment (p<0.01 and p<0.04; FIG. 20B).Moreover, progesterone significantly increased KS83 diabody treatment by19.1±3% over KS83 treatment alone (p<0.05). Although not significant,progesterone also increased KS49 mediated cell death by 8.1±3% over KS49treatment alone (p=0.07).

The annexin V and propidium iodide staining suggested that anti-EMP2diabodies induced an apoptotic mode of cell death in RL95-2 cells. Tovalidate this effect, cells were treated with 12.5 μg/ml of the EMP2specific diabodies KS83 and KS49 or control diabody A10 in the presenceor absence of progesterone for 24-36 hours. EMP2 and active caspase 3was measured in equivalent cell lysates by western blot analysis (FIG.19C). As expected, progesterone treatment augmented EMP2 expression byapproximately 2.5 fold (FIG. 19C, left). Strikingly, significantdifferences in cleaved caspase 3 was detected upon addition of KS83compared to the control diabody A10 (p<0.05) (FIGS. 19C and D).Strikingly, significantly higher levels of activated caspase 3 weredetected upon addition of progesterone and KS49 and KS83 compared to thecontrol A10 (p<0.05; p<0.01, respectively). These results suggest thatprogesterone and KS49 or KS83 act synergistically to induce apoptosis ofendometrial cancer cells.

H. In Vivo Tumor Targeting.

In order to evaluate the preclinical efficacy of EMP2 therapy, thetoxicity of two anti-EMP2 diabodies (KS49 and KS83), and a controldiabody (A10) were assessed for toxicity in wildtype C57BL/6 mice. KS49and KS83 bind a shared epitope in mouse and human EMP2, and are thususeful for assays for toxicity to normal tissues, as well as therapeuticmodeling in xenograft assays. To assess normal tissue toxicity,anti-EMP2 and control diabodies were parenterally administered each twodays (ranging up to 9 mg/kg) over two weeks in wildtype mice (C57BL/6).No changes were observed in animal weight, or in serum metabolicanalytes for liver function (Table 1). Gross and microscopic examinationof tissues also showed no abnormalities (data not shown). Notably, thisexamination reflected an absence of toxicity in lung and skin, whichexpress high levels of EMP2 (Wang et al., Blood 97:3890-5 (2001); Ben etal., Genomics, 49:443-7 (1998)). Thus, in this limited analysis, notoxicity was detectable by anti-EMP2 diabody to normal tissues.

TABLE 1 Effect of parenteral diabody. Mice were injected i.v. withsterile saline, control diabody A10, or anti-EMP2 diabodies (K83 or K49)biweekly for 14 days. Direct Total Starting Final Bilirubin BilirubinALT Weight Weight (mg/dL) (mg/dL) (U/L) Vehicle 19.9 ± 0.7 19.8 ± 0.4 00.2 45 ± 6 Control A10 18.7 ± 0.2 19.5 ± 1.7 0 0.2 36 ± 8 K83 18.9 ± 0.919.8 ± 0.9 0 0.2 44 ± 8 K49 19.9 ± 1.4 20.3 ± 0.1 0 0.2 37 ± 7 3 micewere utilized per group. Mouse weights were determined at the startingand final day, and serum analytes were determined from blood obtained onthe final day.

In order to evaluate the efficacy of anti-EMP2 diabodies in vivo, anendometrial cancer xenograft model was created. Tumors from HEC-1A/V andHEC-1A/OE cells were established in the shoulder flanks of female BALB/cnude mice. After detectable tumor formation (day 13), anti-EMP2 diabodyKS83, control A10, or a vehicle control (sterile saline) were injectedbiweekly intra-tumorally, and progression of tumor size was measured bycalipers. By day 30, KS83 had profoundly inhibited tumor growth of bothHEC-1A/V and HEC-1A/OE tumors (FIG. 20A).

Tumors were excised on day 30. Interestingly, in vivo, both HEC-1A/V andHEC-1A/OE tumors revealed high, comparable levels of EMP2 expression(FIG. 20B). In tumors from both cell types, high levels of EMP2 wereobserved within the cytoplasm as well as on the membrane. Moreover,excised tumors revealed greater than 4-fold differences in tumor sizebetween KS83 and A10 treatment in HEC-1A/V cells and HEC-1A/OE cells(FIG. 19C, D). Within HEC-1A/V tumors, hemotoxylin and eosin stainingrevealed large areas of necrosis in tumors treated with KS83 but notwith A10 (FIG. 20C). Necrosis was more pronounced in KS83 treatedHEC-1A/V than HEC-1A/OE tumors, perhaps as the result of clearance byimmune cells (FIG. 20D).

In conclusion, treatment of endometrial adenocarcinoma cells with anhighly specific anti-EMP2 diabody resulted in a significant increase incaspase-dependent apoptotic cell death in vitro and a reduction in tumorvolume in vivo. These data support EMP2 as a therapeutic target and theuse of anti-EMP2 antibodies in the treatment of cancers which express oroverexpress EMP2.

Each publication, patent application, patent, and other reference citedherein is incorporated by reference in its entirety to the extent thatit is not inconsistent with the present disclosure. In particular, allpublications cited herein are incorporated herein by reference in theirentirety for the purpose of describing and disclosing the methodologies,reagents, and tools reported in the publications that might be used inconnection with the invention. Nothing herein is to be construed as anadmission that the invention is not entitled to antedate such disclosureby virtue of prior invention.

Although the foregoing invention has been described in some detail byway of illustration and example for purposes of clarity ofunderstanding, it will be readily apparent to those of ordinary skill inthe art in light of the teachings of this invention that certain changesand modifications may be made thereto without departing from the spiritor scope of the appended claims.

We claim:
 1. A method for treating cancer in a subject the methodcomprising the administration of an antibody that binds to EpithelialMembrane Protein 2 (EMP2) wherein the antibody is an isolated antibodythat competes for binding to the extracellular loop of human EpithelialMembrane Protein 2 (EMP2) (SEQ ID NO: 42) with an EMP2 inhibitor,wherein the antibody comprises a heavy chain variable region and a lightchain variable region, wherein the heavy chain variable region comprisesthree heavy chain complementary determining regions (HCDRs) and whereinthe light chain variable region comprises three light chain variableregions (LCDRs), wherein: the sequence of HCDR1 is SEQ ID NO: 15, thesequence of HCDR2 is SEQ ID NO: 17, the sequence of HCDR3 is SEQ ID NO:41, the sequence of LCDR1 is SEQ ID NO: 20, the sequence of LCDR2 is SEQID NO: 23, and the sequence of LCDR3 is SEQ ID NO:
 40. 2. The method ofclaim 1, wherein the cancer is selected from the group consisting ofendometrial cancer, ovarian cancer, glioblastoma, breast cancer,prostate cancer, testicular cancer and myeloma.
 3. The method of claim2, wherein the cancer is endometrial cancer.
 4. A method for treatingcancer in a subject the method comprising the administration of anantibody that binds to Epithelial Membrane Protein 2 (EMP2) wherein theantibody is an isolated antibody which binds to Epithelial MembraneProtein 2 (EMP2), wherein the antibody comprises a heavy chain variableregion and a light chain variable region, wherein the heavy chainvariable region comprises three heavy chain complementary determiningregions (HCDRs) and wherein the light chain variable region comprisesthree light chain complementary determining regions (LCDRs), wherein:the sequence of HCDR1 is SEQ ID NO: 15, the sequence of HCDR2 is SEQ IDNO: 17, the sequence of HCDR3 is SEQ ID NO: 41, the sequence of LCDR1 isSEQ ID NO: 20, the sequence of LCDR2 is SEQ ID NO: 23, and the sequenceof LCDR3 is SEQ ID NO:
 40. 5. The method of claim 4, wherein the canceris selected from the group consisting of endometrial cancer, ovariancancer, glioblastoma, breast cancer, prostate cancer, testicular cancerand myeloma.
 6. The method of claim 5, wherein the cancer is endometrialcancer.